天长市第一医共体牵头医院医疗服务有序性分析  

Orderliness Analysis of Medical Services in Leading Hospital of the First Medical Community in Tianchang City

作　　者：冯华刚[1] 王洁[2,3] 湛大顺 闫朝阳 张翔 叶青跃[4] Feng Huagang(Tongji Hospital,Tongji Medical College of HUST,Wuhan,43003)

机构地区：[1]华中科技大学同济医学院附属同济医院,武汉430030 [2]华中科技大学同济医学院医药卫生管理学院,武汉430030 [3]湖北省人文社科重点研究基地农村健康服务研究中心,武汉430030 [4]武汉科技大学附属天佑医院,武汉430064

出　　处：《医学与社会》2018年第10期47-50,共4页Medicine and Society

基　　金：国家自然科学基金项目;编号为71373091

摘　　要：目的:分析天长市第一医共体牵头医院的有序性、动力和阻力因素,为县域医共体建设提供参考。方法:描述性分析牵头医院及其下辖乡镇卫生院服务提升情况,利用信息熵模型计算医疗服务体系系统运行熵,利用灰色关联计算医疗服务体系内部结构关联熵。结果:牵头医院人力资源总量增长3%,业务收支结余率、总资产周转率约增加2%,药占比和耗材占比也呈现整体下降趋势,医疗服务质量总体没有发生较大变化,下辖乡镇卫生院服务能力和服务技术有所提升。医疗服务各季度熵值约为1.26-1.27。关联熵评价结果显示,各指标与总体满意度的关联系数大多在0.7以上,其中药占比X3、新农合实际报销比X5与下转人数的关联性最强,均>0.9,门诊输液率X11则最低。结论:牵头医院总体处于低度有序性状态,有向无序发展的趋势,其医疗服务有序性的动力因素是控制医疗费用,阻力因素是过度降低门诊输液率。Objective： To analyze the orderliness, motivation and resistance factors of the first medical community leading hospital in Tianchang City after its participation in the medical community construction, to provide reference for the construction of medical community in the county. Methods： Based on a descriptive analysis of the improvement of services provided by leading hospital and township hospitals, the information entropy model was used to calculate the operational entropy of the medical service system and the grey system was used to calculate the internal structure entropy of the medical service system. Results： The total human resources of Tianchang People＇s Hospital increased by 3%. The business balance of payments and total assets turnover increased by about 2%. The proportion of medicine and consumables also showed an overall downward trend. The overall quality of medical services did not change significantly. Its subordinate township hospitals improved service capabilities and service technology. Quarterly entropy values of medical services were approximately 1.26-1.27. The correlation entropy evaluation results showed that the correlation coefficient between each index and overall satisfaction was mostly above 0.7. Conclusion： The leading Hospital is in an overall low order and tend to develop in a disorderly manner. The driving factor in the orderly development of leading hospitals is the control of medical expenses, and the resistance factor is the excessive decrease of outpatient infusion rate.

关 键 词：县域医共体 幸头医院 有序性 天长 

分 类 号：R19-0[医药卫生—卫生事业管理]