基于社会监督的公立医院信息公开现状及公开意愿调查

Investigation and analysis of information disclosure status and willingness of public hospitals based on social supervision

目的:调查三级、二级公立医院基于社会监督的信息公开现状及公开意愿,为推进公立医院信息公开提供参考。方法:采用分层整群随机抽样方法,于2021年4月,抽取6个省份的66家三级公立医院和126家二级公立医院进行问卷调查。选取医疗服务信息、医疗费用信息和满意度信息3类5组31个指标,调查公立医院的信息公开现状与公开意愿;采用 χ2检验、方差分析和配对 t检验进行差异性分析,研究信息公开内容拓展策略。 结果:公立医院信息公开比例较高的指标是药品价格和医疗服务价格调整(三级医院93.9%,二级医院92.1%)以及医保报销政策和补偿流程(三级医院90.9%,二级医院86.5%),公开比例较低的指标是低风险组病例死亡率(三级医院24.2%,二级医院26.2%)、特需医疗服务占比(三级医院27.3%)和每名执业医生日均门诊量(三级医院27.3%,二级医院26.2%)。公立医院认为能公开比例较高的指标是药品价格和医疗服务价格调整、医保报销政策和补偿流程以及常用药品和主要医用耗材的价格及医保报销情况,认为能公开比例较低的指标为部分医疗服务安全指标和医院财务类指标。医院对所有指标认为能公开比例均高于已公开比例。结论:现阶段我国二级及以上公立医院对医疗服务效率、医疗服务安全、统计汇总类费用、财务类指标公开较少,但除部分医疗服务类指标、财务相关指标外,医院的信息公开意愿均较高,可分步有序扩大信息公开范围。

ObjectiveTo investigate the status and willingness of information disclosure based on social supervision in tertiary and secondary public hospitals,so as to provide reference for expanding information disclosure content.MethodsBy using stratified cluster random sampling method,66 tertiary public hospitals and 126 secondary public hospitals in 6 provinces were selected for questionnaire survey in April 2021.Thirty-one indicators in 3 categories and 5 groups were selected to obtain the information disclosure status and willingness.Chi-square test,variance analysis and paired t-test were used to conduct difference analysis.ResultsThe indicators with higher disclosure rates in public hospitals were drug prices and medical service price adjustments(93.9%in tertiary hospitals and 92.1%in secondary hospitals)and medical insurance reimbursement policies and compensation processes(90.9%in tertiary hospitals and 86.5%in secondary hospitals),while the indicators with lower disclosure rates were case fatality rates in low-risk groups(24.2%in tertiary hospitals and 26.2%in secondary hospitals),proportion of special needs medical services(27.3%in tertiary hospitals),and average daily outpatient visits per practitioner(27.3%in tertiary hospitals and 26.2%in secondary hospitals).The indicators that public hospitals thought could be disclosed at a higher rate were drug and medical service price adjustments,medical insurance reimbursement policies and compensation processes,and prices and medical insurance reimbursement of commonly used drugs and major medical consumables,while the indicators that were thought to be disclosed at a lower rate were some medical service safety indicators and hospital financial indicators.For all indicators,the percentage that the hospitals thought could be disclosed was higher than the percentage that had been disclosed.ConclusionsAt present,China′s secondary and tertiary public hospitals have a low rate of disclosure about medical service efficiency,medical service safety,statistical summary cost and financial indicators.However,except for some medical service indicators and financial related indicators,the hospitals′information disclosure willingness is relatively high,and the scope of information disclosure can be expanded in an orderly manner in steps.