医院依法执业自查指标体系构建研究

Study on the construction of self-examination index system for hospital legal practice

目的:构建医院依法执业自查指标体系,为医院依法执业自查工作提供有效参考。方法:2021年5月至2022年9月,通过文献阅读法和专家访谈法,初步构建多维多层次的指标体系;应用德尔菲专家咨询法进行3轮函询,邀请专家对指标的重要性进行评估,运用层次分析-模糊综合评价法计算指标权重值。结果:咨询专家对于调查内容熟悉程度Cs值为0.84,判断依据Ca值为0.78,权威性评价Cr值为0.81,Kendall W值为0.630。构建的医院依法自查指标体系包含5个一级指标、19个二级指标和30个三级指标。5个一级指标包括机构执业、人员执业、消毒与传染病防治、线上诊疗和打击欺诈骗保,其权重分别为0.235、0.186、0.188、0.185、0.206;二级指标中,合理使用医保基金、互联网医院和互联网诊疗、机构资质和执业行为4个指标的权重最高,分别为0.206、0.185、0.122和0.113;三级指标中互联网医院医师资质、医院是否取得执业许可证、打击欺诈骗保行为、实名就医、合理规范使用医保费用5个指标的权重最高,分别为0.185、0.122、0.076、0.065和0.065。 结论:本研究构建的医疗机构依法执业自查指标体系科学性较好,有助于引导医疗机构依法执业自查,确保医疗质量和安全。

ObjectiveTo construct a self-examination index system for hospital legal practice,and provide effective reference for the self-examination work of hospital practice in accordance with the law.MethodsFrom May 2021 to September 2022,a multi-dimensional and multi-level indicator system was initially constructed through literature review and expert interviews;Delphi expert consultation method was used to carry out a three-round questionnaire survey,experts were invited to assess the importance of indicators,and the weight values of indicators were processed by using analytic hierarchy process-fuzzy comprehensive evaluation method.ResultsThe Cs value of consulting experts′familiarity with the survey content was 0.84,Ca value of judgment basis was 0.78,Cr value of authoritative evaluation was 0.81,and Kendall W value was 0.630.The index system of hospital self-examination included 5 first-level indexes,19 second-level indexes,and 30 third-level indicators.The 5 first-level indicators included institutional practice,personnel practice,disinfection and prevention of infectious disease,online diagnosis and treatment,and anti-fraud insurance,with weights of 0.235,0.186,0.188,0.185,and 0.206 respectively.Among the second-level indicators,the weights of rational use of medical insurance fund,internet hospital and internet diagnosis and treatment,organization qualification and practice behavior were the highest,with values of 0.206,0.185,0.122 and 0.113 respectively.Among the third-level indicators,the internet hospital physician qualification,whether the hospital had obtained the license to practice,cracking down on fraudulent insurance practices,real-name medical treatment,and reasonable and standardized use of health insurance costs had the highest weight,which were 0.185,0.122,0.076,0.065,and 0.065,respectively.ConclusionsThe self-examination index system of medical institutions is scientific,which could help the medical institutions to practice self-examination and ensure medical quality and safety.