多院区医疗同质化管理内部评价方法研究

Study on Internal Evaluation of Uniform Care Management in Multi-campus Hospital

目的探索多院区内部同质化管理效果的定量评价方法,为建立多院区内部医疗同质化评价机制提供思路。方法综合《国家三级公立医院绩效考核指标体系》《三级医院评审标准》(2020年版)和医院内部医疗质量指标监测体系,结合数据质量和特异性,选择病例组合指数、时间消耗指数、费用消耗指数、治愈率、好转率及病死率等6项指标,对某多院区医院2020年7—12月21个临床科室在3个院区、63个核算单元医疗质量数据进行方差分析,以比较同一科室在不同院区的医疗质量是否存在统计学上的差异。结果21临床科室在3个院区的6项指标均无统计学差异。结论通过筛选适宜的指标,采用统计学方法进行检验,可以建立多院区同质化管理的内容评价机制,进而促进多院区同质化管理。

Objective To explore the quantitative evaluation method of internal homogeneous care management effect in multi-campus hospital,and to provide ideas for the establishment of internal uniform care evaluation mechanism.Methods Based on the National Performance Appraisal Index System for Tertiary Public Hospitals,Evaluation Standards for Tertiary Hospitals(2020 Edition)and the internal medical quality index monitoring system of hospitals,six indexes,including CMI value,time consumption index,cost consumption index,cure rate,improvement rate and case fatality rate,were included in combination with data quality and specificity.Analysis of variance(ANOVA)was conducted on the medical quality data of 63 accounting units from 21 clinical departments in the three campuses in a multi-campus hospital from July to December in 2020 to compare whether there was statistical significance in the medical quality of the same department in different campuses.Results There was no statistical significance in the6 indexes of 21 clinical departments in these three campuses.Conclusion The content evaluation mechanism of multi-campus hospital uniform care management can be established by screening suitable indexes and applying statistical methods,thereby promoting the homogeneous management of multiple hospital districts.