某大学三所附属医院手术分级管理现况调查  

The Current Investigation of Operation Grading Management in Three Affiliated Hospitals of One University

作　　者：赵佳[1] 徐长妍[1] 刘玉霞[2] 王江华[3] 

机构地区：[1]吉林大学第一医院,长春市130021 [2]吉林大学中日联谊医院,长春市130033 [3]吉林大学第二医院,长春市130041

出　　处：《中国病案》2015年第2期18-20,共3页Chinese Medical Record

基　　金：吉林大学医院管理研究资助项目(2013012)

摘　　要：目的了解某大学三所附属医院手术分级管理现状,得出相关结论,为建立合理的手术分级目录及管理制度提供数据支持。方法从某大学三所附属医院的病案首页录入系统中检索2012年与2013年的手术病例254962份,统计分析病例资料。结果三所附属医院的三、四级手术比例分别为47.52%、58.93%和46.20%;三所医院合计的数据中,三、四级手术构成比为50.24%;在各级专业技术职称的医师中,带组教授完成手术的构成比分别为64.93%、97.24%和89.55%,远远高于经治医师与主治医师完成手术的构成比;带组教授完成的手术权限范围内的手术占同级别手术的构成比最高,三所附属医院的构成比分别为87.15%、98.43%和92.58%。结论三所附属医院的高级别手术比例不足,在区域卫生医疗方面上,还没有真正发挥出三级甲等医院的作用;存在高级别专业技术职务的医师垄断手术的现象。建议根据各级医师的专业特长、手术操作技术水平等实际情况,科学实施手术分级管理,建立合理的手术分级目录及管理制度,并实行动态管理,充分发挥医院在区域卫生医疗中的作用。Objective To understand the current situation of operation grading management of three affiliated hospitals of one university and draw relevant conclusions to provide data support for the establishment of a reasonable classification directory and management system of operation grading. Methods A total of 254962 operation cases from year 2012 to 2013 were retrieved through the medical record entry system of the three affiliated hospital of one university. A statistical analysis was employed for the clinical data.Results The percentage of three or four stage operations of such three affiliated hospitals were 47.52%, 58.93% and 46.20% respectively; In the total data of these three hospitals, the constituent ratio of three or four stage operations was 50.24%. In the constituent ratios of the operations completed by the doctors with professional and technical title in every level, the percentage of operations completed by the group leading professors was far more than that of the resident doctors or the attending doctors, the percentages of three affiliated hospitals of one university were 64.93%, 97.24% and 89.55%respectively. The operations completed by the group leading professors in their scope of permission accounted for highest constituent ratio of the operations at the same level; the percentages of three affiliated hospitals of one university were 87.15%, 98.43%and 92.58%. Conclusion There are the deficiencies of percentages of high level operations in the three affiliated hospitals. The hospitals can’t play the real role of the third level and first-class hospital in the regional health care. There is the presence of the monopoly on the operations by the doctors with high professional and technical levels. It is suggested to implement the classification management scientifically and establish the operation classification directory as well as the reasonable operation management system according to the actual situations of the expertise and the operation technical level of the doctors at every level, and to e

关 键 词：手术分级 手术权限 医院管理 

分 类 号：R197.3[医药卫生—卫生事业管理]