基于加权TOPSIS法的城市纵向医联体分级诊疗效果评价研究

Evaluation of the implementation effect of hierarchical healthcare of city vertical medical consortium with the application of weighted TOPSIS method

目的对由三级医院和基层医疗卫生机构组建的城市纵向医联体,从基层首诊、双向转诊、急慢分治、上下联动4个方面进行综合评价,研究其分级诊疗实施效果,为在不同环境下构建多模式的医联体服务体系提出建议。方法研究前期通过德尔菲法和层次分析法构建分级诊疗效果评价指标体系,并利用加权TOPSIS法横向对比样本医联体分级诊疗效果,进行综合评价后得到排序结果。结果基于分级诊疗实施效果评价指标的加权TOPSIS法,其计算结果与实际开展情况切合,3组评价样本的综合评价系数分别为0.5157、0.5423和0.4564。结论构建城市纵向医联体,以实现网格化布局管理为目标,应明确基层功能定位,根据其自身特点和资源分布,形成多模式合作机制,进一步推进分级诊疗制度的实施。

Objective To evaluate the implementation effect of graded diagnosis and treatment of urban longitudinal medical consortium formed by tertiary hospital and primary health care institutions from the dimensions of primary consultation,two-way referrals,acute and chronic disease and up-down linkage,and provide references for building a multi-mode medical consortium service system in different environments.Methods Early in the research,the Delphi method and the analytic hierarchy process were used to construct an evaluation index system of graded diagnosis and treatment effect,and the weighted TOPSIS method was used to horizontally compare the graded diagnosis and treatment effects of samples,and the ranking results were obtained after comprehensive evaluation.Results The results based on weighted TOPSIS method for evaluating the implementation effect of graded diagnosis and treatment were consistent with the actual situation.Ci values were 0.5157,0.5423,0.4564 respectively.Conclusion To build city vertical medical consortiums requires grid layout management.Primary healthcare institutions should be clearly aware of their functional positioning.According to the distribution and characteristics of community health centers'resources,a multi-mode cooperation mechanism is formed to further promote the implementation of the hierarchical diagnosis and treatment system.