新型冠状病毒感染疫情期间医疗设备管理影响因素分析

Factors affecting medical device management in COVID-19 pandemic

目的:探讨新型冠状病毒感染(COVID-19)疫情期间医疗设备管理的影响因素,为突发公共卫生事件时的医疗设备管理提供借鉴。方法:选取江苏、浙江、上海、安徽和山东的184家收治COVID-19患者的医院,以其临床工程人员为调查对象进行随机抽样。采用自行编制的调查问卷,于2021年8—12月就COVID-19疫情期间医疗设备管理影响因素进行在线问卷调查。通过探索性因子分析确定COVID-19疫情期间医疗设备管理影响因素指标体系,然后采用结构方程模型验证该指标体系的合理性与科学性,并采用相关权重法计算指标体系的权重。结果:回收有效问卷277份。通过探索性因子分析建立了包括人力要素、设备要素、物质要素、方法要素和环境要素5个一级指标、17个二级指标的医疗设备管理影响因素指标体系。最终拟合的二阶结构方程模型的适配度指标:χ2与自由度比值为2.606,近似误差均方根为0.076,增值适配指标、非规范适配指标、比较适配指标值分别为0.921、0.903和0.920。一级指标人力要素、设备要素、物质要素、方法要素和环境要素的权重分别为0.216、0.191、0.175、0.274和0.144。17项二级指标中权重位列前3位者为人员配置(0.090)、法规和制度流程(0.082)和信息化管理(0.080)。结论:本研究拟合的COVID-19疫情期间医疗设备管理影响因素模型较理想;COVID-19疫情期间,人力要素和方法要素是医疗设备管理中需要重点关注的影响因素,应将确保足够的人力资源配置、完善法规和制度流程建设以及提高信息化管理水平作为医疗设备管理的新突破口。

Objective To explore the factors affecting the management of medical devices in the COVID-19 pandemic,and to provide guidance for the management of medical devices in public health emergencies.Methods A total of 184 hospitals caring COVID-19 patients in Jiangsu,Zhejiang,Shanghai,Anhui and Shandong were selected,and clinical engineers were randomly sampled.A self-compiled questionnaire was used to conduct an online survey on factors affecting medical device management during the COVID-19 pandemic from August to December 2021.The index system of influencing factors of medical device management during the COVID-19 pandemic was determined through an exploratory factor analysis,and then the structural equation model was used to verify the rationality and scientificity of the index system,while the relative weight method was used to calculate the weight of the index system.Results 277 valid questionnaires were recovered.Through the exploratory factor analysis,an index system of influencing factors of medical device management was established,which consisted of such level-indexes as the human factor,device factor,material factor,method factor,and environment factor,as well as 17 level-2 indexes.The fitness-indexes of the second-order structural equation model were finally fitted as follows:the chi-square to freedom ratio was 2.606,the approximate root mean square error was 0.076,and the value of value-added adaptation index,non-standard adaptation index and comparative adaptation index were 0.921,0.903 and 0.920,respectively.The weights of the method factor,human factor,device factor,material factor and environment factor of the level-1 indexes were 0.216,0.191,0.175,0.274 and 0.144,respectively.Such factors as manpower,regulations and institutional processes,and information technology ranked top three among the 17 level-2 indexes,which were 0.090,0.082 and 0.080 respectively.Conclusions The influencing factor model of medical device management during the COVID-19 pandemic in this study is ideal;human factors and method factors are the influencing factors deserving high priority in medical device management during the COVID-19 pandemic.Ensuring sufficient human resources,improving laws,regulations and processes,as well as enhancing information management level are breakthroughs expected in medical device management.