基于综合数据分析的日间手术绩效分配方案设计与效果评估

Design and effect of the performance distribution for day surgery based on comprehensive data analysis

目的通过合理的绩效分配方案,最大限度激发医护积极性,提高日间手术效率与效益,提升医疗服务质量。方法运用数据分析方法,获取日间手术目录术种既往住院时长、手术级别、手术方式等指标,遵循“高水平医院主要收治疑难危重病种,优劳优得,多劳多得”绩效分配原则,实行术种分类奖励政策,建立日间手术绩效分配字典库,并形成相应报表。结果方案实施后,日间手术术种较前提高约1.67倍,24 h出院的日间手术占择期手术比重提升至15.6%,工作量稳步提升;医院三、四级手术占日间手术比例提升至68.60%,且四级手术实现零的突破,同时非计划再次手术发生例数和非计划7 d内再入院例数这两个指标皆保持为零,工作质量持续改进;医院平均住院日较前下降约7.26%,术前平均住院日下降约11.96%,重点术种由原来的住院时长超48 h缩短至24 h以内,运行效率持续优化。结论数据分析是绩效方案设计的有效方法之一。实行按术种分类奖励政策的绩效方案可有效提高三级公立医院日间手术的工作量、工作质量和运行效率,具有一定的可操作性、可追溯性和可推广性。

Objective Through reasonable performance distribution scheme,the enthusiasm of medical staff can be stimulated,and the efficiency and benefit of day surgery can be improved which can also improve the quality of medical service.Methods The data analysis method was used to obtain the previous hospitalization duration,operation level,operation method and other indicators of the day surgery catalog.Based on the performance distribution principle of“high-level hospitals mainly treat difficult and critical diseases,get the best for the best,and get more for the more”,the reward policy for the types and classification of surgery was implemented.After all,a dictionary for day surgery performance distribution was established as well as the form corresponding reports.Results Based on the implementation of the performance distribution scheme,the type of day surgery increased by about 1.67 times compared to the previous one,and the proportion of day surgery discharged within 24 hours in elective surgery increased to 15.6%,with a steady increase in workload.The proportion of Level III and Level IV operations in hospital day surgery increased to 68.60%,and Level IV operations achieved a breakthrough of zero.At the same time,both the number of unplanned reoperations and the number of unplanned readmissions within 7 days remained zero.The quality of work improved obviously.The average length of stay in hospital decreased by about 7.26%compared to the previous period,as well as the average preoperative stay decreased by about 11.96%.The length of stay for key types surgery was shortened from over 48 hours to less than 24 hours.The operational efficiency continued to be optimized.Conclusion Data analysis was one of the effective methods for performance scheme design.The implementation of a performance scheme with the incentive policy classified by surgical species can effectively improve the workload,work quality and operation efficiency of day surgery in tertiary public hospitals,which has some operability,traceability and generalizability.