规范化诊疗行为的影响因素及模式的建立  

The influence factors and mode establish of standardization diagnosis and treatment behavior pattern

作　　者：杨志寅[1] 孔令斌[1] 杨震[2] 张作记[1] 戚厚兴[3] 

机构地区：[1]济宁医学院山东省行为医学教育研究所,济宁272013 [2]复旦大学附属中山医院 [3]济宁医学院附属医院

出　　处：《中国行为医学科学》2006年第3期234-236,共3页Chinese Journal of Behavioral Medical Science

基　　金：山东省教育科学规划项目资助(J05L16)

摘　　要：目的建立医务人员的规范化诊疗行为模式,探讨其在医院管理和决策中的应用。方法在两所三级甲等、三级乙等医院里,随机抽取20个科室里的196个医生和他们分管的196例患者作为本次研究的对象。分别按照预先设计好的“诊断行为调查表”对选取的医生和患者进行现场询问调查,将对医生的调查结果和对其所诊治的病人的调查结果进行“拟合优度”检验,将医生和病人都认为满意的诊疗行为作为诊疗行为中的规范,建立诊疗行为标准。结果研究发现:医生的业务理论水平、临床实践操作技能水平、人文知识的掌握、合理用药、病人的平均住院日和患者出院后医生对患者的随访是医生和患者公认的影响医生诊疗行为的因素:其贡献率分别为0.673,1.283,0.761,0.948,2.012和1.038。结论为了使医生的诊疗行为更加科学、规范,医务人员应加强自身的业务理论学习,不断提高临床实践操作水平。Objective To explore influence factors and mode establishes of standardization diagnosis and treatment behavior pattern for the medical personnel, explore application of diagnosis and treatment behavior pattern when managed hospital and make hospital policy. Methods random selected 196 doctors and 196 patients of 20 clinical departments , they were from three class first grades and three class second grade hospital and regard as this investigative objects. According to in advance designed ＂questionnaire of diagnosis and treatment behavior＂ proceed into experimental field to inquires the inquisitions, Proceed ＂likehood good test＂ analysis , if the diagnosis and treatment behavior factors of the doctorg inquisition same as that of the patients inquisition,we think this factors should be as our to diagnosis and treatment behavior norm in the future , establish to diagnosis and treatment behavior standard. Results This research discovers the factors that effects the medical personnel diagnosis and treatment behavior mainly includes： The doctorg theories level, clinical practice and operate the technical ability level, surroundings persons to doctors＇ diagnosis and treatment level to approve, doctor spend the medicine that patients use money how much and the day in average hospitalization of the result quality, doctors＇follow up to patients after patients getting out of the hospital . Conclusion For the sake of better service in patients, make medical personnel behavior more science and norm, the medical personnel should enhance their theories study , continuously increases the clinical practicing operates level; control to patients＇mental state and technique of connected with patients, set up whole heartedly Service for patients, inerease the rate of turnover of the hospital sickbed, enhance to patients follow up after patients getting out hospital.

关 键 词：规范化 诊断行为 治疗行为 模式 

分 类 号：R197.3[医药卫生—卫生事业管理]