国考背景下多院区的手术指标管理探讨

Surgical rate indicators management in multi-campus hospitals under the background of national assessment

目的探讨多院区发展过程中分院区国考手术统计指标有效提升途径。方法选取2023年度上半年两院区同方向A1、A2两个手术科室的病案首页数据,通过分析患者一般情况、四级手术术式、非四级手术术式、收治病种,找出差异原因并提供改进措施。结果分院区A2科室腹腔镜检查术式数量远高于主院区A1科室(P<0.01),且分院区A2科室收治以化学治疗、恶性黑色素瘤为主要诊断的患者比例高于主院区A1科室(P<0.01),是影响分院区手术率指标的重要因素。结论通过对病案首页数据系统分析,可有效发现院区之间同方向术科国考手术指标差异原因。落实门诊特定病种管理办法、鼓励收治疑难危重患者是提高科室手术率及四级手术率的有效途径。当分院区存在因为暂不可调节的影响因素导致手术率指标差异时,分院区与主院区应设置不同的管理目标值。

Objective Toexplore a path to improving surgical operation statistical indexes during the expansion of multi-campus hospitals.Methods In this study we selected the data from the medical records of two surgical departments(A1 and A2)from two campuses of a hospital in the first half of 2023,following by analyzing patients’general information,fourth-level surgical procedures,non-fourth-level surgical procedures,and disease types to identify the reasons for the discrepancies in the indicators between the two departments and make suggestions for improvement.Results The A2 department in the branch hospital performed significantly more laparoscopic procedures than the A1 department in the home hospital(P<0.01).Moreover,the prevalence of the patients diagnosed with chemotherapy and malignant melanoma in the A2 department was significantly higher than in the A1 department(P<0.01),impacting the surgical rate indicator for the branch area.Conclusion A systematic analysis of medical record data can effectively pinpoint the reasons for indicator discrepancies among different campuses within the same surgical departments of a hospital.Implementing outpatient-specific disease management and encouraging admission of complex and critically ill patients can effectively enhance the surgical rate as well as the fourth-level surgical rate in a department.It is suggested for the home hospital and its branches to set a respective indicator management target as long as the gap in the factors influencing the surgical rate indicators is unbridgeable between the campuses.