某三甲医院医疗质量综合评价及影响因素分析

Evaluation of Medical Quality and Analysis of the Influencing Factors in a 3A Hospital

目的评价广东省某三甲医院医疗质量运行情况,为医疗质量体系构建和持续改进提供依据。方法通过专家咨询法构建5个一级指标、17个二级指标的医疗质量管理评价指标体系,对2010—2020年医疗质量指标数据进行基于熵权的TOPSIS法综合评价;应用多元线性回归模型探寻综合评价结果的影响因素。结果医院2010—2020年医疗质量指标数据综合评价结果呈现波动递增趋势,评价结果与医院实际情况基本吻合;急诊诊疗人次、门诊手术量、微创手术量、临床路径入径率是医院医疗质量水平的主要影响因素(P<0.001)。结论基于熵权的TOPSIS法能够客观准确地了解医院的综合医疗质量变化情况,有助于确定医疗质量持续改进方向和进一步提升医院医疗质量规范化管理水平。

Objective:To evaluate the operational status of medical quality in a 3A hospital in Guangdong Province,and provide a basis for the construction and continuous improvement of the medical quality system.Method:An evaluation index system of medical quality management with 5 first-level indicators and 17 second-level indicators was established with the expert consultation method.TOPSIS method based on entropy weight was used to comprehensively evaluate the data of medical quality indicators from 2010 to 2020.Multivariate linear regression model was used to explore the influencing factors of the comprehensive evaluation results.Result:The comprehensive evaluation results of medical quality indicators from 2010 to 2020 showed a fluctuating and increasing trend,and the evaluation results are basically consistent with the actual situation of the hospital;The numbers of emergency diagnosis and treatment,outpatient surgery,minimally invasive surgery,and the clinical pathway entry rate are the main influencing factors of hospital medical quality level(P<0.001).Conclusion:TOPSIS method based on entropy weight can objectively and accurately understand the changes of comprehensive medical quality in hospitals,help to determine the direction of continuous improvement of medical quality and further improve the standardized management level of hospital medical quality.