以临床路径管理为基础的医疗服务管理绩效评价

Medical service management performance evaluation system based on clinical pathway management

目的探讨以临床路径管理为基础的医疗服务管理绩效评价指标和权重,为构建完善的绩效评价体系提供参考。方法检索网络资料库和相关书籍,初步筛选以临床路径管理为基础的医疗服务管理绩效评价指标,并咨询专家意见进行3次修改,构建绩效评价体系。进而由专职测评人员采用加权平均法对2015年我院2型糖尿病、腹腔镜卵巢囊肿切除术、慢性胆囊炎三种疾病进行医疗服务管理实施评价,并对三种临床路径的缺陷率进行计算。结果绩效评价体系由一级指标7个和二级指标30个构成,其中经营成效指标的权重最高。通过对该绩效评价体系进行测试,3种疾病的7个一级指标平均评分均低于标准分,差异均有统计学意义(P<0.05)。各项评价指标缺陷率最低者均为腹腔镜卵巢囊肿切除术,其次为2型糖尿病,慢性胆囊炎指标缺陷率最高,且缺陷率表现最高的均为组织领导作用,分别为36.75%、38.52%和32.82%。结论以临床路径管理为基础建立完善的医疗服务管理绩效评价系统,能够对各种疾病的治疗管理提供指导,并对现行的临床路径中存在的问题给予完善,具有重要的医院推广价值。

Objective To study the index and weight clinical pathway management-based medical service management performance evaluation, and to provide reference for building perfect performance evaluation system.Methods The indexes for medical service management performance evaluation based on clinical pathway management were preliminary screened by retrieving network database and related books, and then revised for 3 times by consulting experts. The performance evaluation system was built. The system was adopted for medical service management performance evaluation in our hospital in 2015 for type 2 diabetes mellitus, laparoscopic oophorocystectomy,chronic cholecystitis with weighted average method. The defect rates of three kinds of clinical pathway were calculated. Results The performance evaluation system included 7 first-class indicators and 30 second-class indicators,with management effectiveness index weighing the highest. Through the test of the performance evaluation system, the average scores of 7 first-class indicators of the three kinds of disease were lower than the norm, and the differences were statistically significant(P<0.05). The defect rates of evaluation indexes were the lowest in laparoscopic oophorocystectomy, followed by type 2 diabetes mellitus, and highest in chronic cholecystitis. The defect rate was the highest for organization leadership in all the three kinds of disease, which were 36.75%, 38.52% and 32.82%, respectively.Conclusion Medical service management performance evaluation system based on clinical pathway management can provide guidance for the treatment and management of various diseases, and can help to improve the existing problems in the current clinical pathway, which has significant promotion value in hospitals.