我国医疗质量多维综合评价方法的循证评价  

Evidence-Based Evaluation on the Multi-dimensional Synthetical Evaluation Method of Medical Quality

作　　者：夏萍[1] 庄岩[2] 卢传坚[1] 陈达灿[1] 邹旭[1] 吴大嵘[1] 程兰[1] 欧爱华[1] 袁秀琴[1] 陈海[1] 胡学军[1] 张忠德[1] 许星莹[2] 蔡坚雄[1] 

机构地区：[1]广东省中医院,广州510120 [2]广州中医药大学经济与管理学院,广州510006

出　　处：《中国循证医学杂志》2011年第2期226-230,共5页Chinese Journal of Evidence-based Medicine

基　　金：中国医院协会2009-2010年度医院管理研究课题(编号:CHA-3-2010-036)

摘　　要：目的循证评价我国医疗质量多维综合评价方法的应用现状,为我国医疗质量的监管提供参考。方法计算机检索CBM(1978～2009)、VIP(1989～2009)、CNKI(1990～2009)、万方中华医学会期刊数据库(1990～2009)及相关官方网站,收集有关我国医疗质量综合评价的文献。语种限中文。结果共纳入文献216篇,其中观察性研究184篇,传统综述29篇,专家意见3篇。216篇文献中,共使用了21种综合评价方法,总被引频次超过30次的方法分别是秩和比法、TOPSIS法和综合指数法,总引用频率依次为19.72%、19.03%和12.80%,三种方法的累计引用率为51.56%。184篇观察性研究文献中,使用1种综合评价方法的文献占89.13%(164/184),使用2种综合评价方法的文献占9.78%(18/184),使用3种综合评价方法的文献占1.09%(2/184)。结论①采用2种或2种以上综合评价方法的研究较少,主要以单一综合评价方法为主,集中于秩和比法、TOPSIS法和综合指数法这3种方法;②综合评价方法的叫法多样,不统一,有的甚至不规范;③大多数文献未对医疗质量综合评价值进行校正;④主要以历年数据进行回顾性综合评价。Objective To enhance medical quality evaluation by conducting a systematic review and evidence-based synthesis of relevant research.Methods Such databases as CBM（1978 to 2009）,VIP（1989 to 2009）,CNKI（1990 to 2009）,WanFang Dissertation database（1997 to 2009）,and relevant websites were searched to identify relevant Chinese studies for the synthetical evaluation on methods evaluating medical quality.Results A total of 216 articles including 184 observational studies,29 traditional reviews,and 3 experts＇ opinions were identified.Twenty-one synthetical evaluation methods were used among 216 articles,and the top three methods which had been quoted more than 30 times were： RSR（19.72%）,TOPSIS method（19.03%）,and comprehensive index（12.80%）.Among the 184 observational research papers,the documents using one kind of comprehensive evaluation took up 89.13%（164/184）,the ones using two kinds of evaluation methods accounted for 9.78%（18/184）,and those using three kinds of methods accounted for 1.09%（2/184）.Conclusion a） The joint use of two or more than two methods is not common.The majority of studies using single comprehensive evaluation method focus on RSR,TOPSIS and comprehensive index method;b） The comprehensive evaluation method is considered non-uniform,some not even standardized;c） Most of the medical literatures do not correct the value of quality assessment;and d） Considerably most studies perform retrospective evaluation with historical data.

关 键 词：医疗质量 综合评价方法 循证评价 

分 类 号：R-03[医药卫生]