医院单床效率的三维评价模型构建研究  

Construction and application of three-dimensional evaluation model of single bed efficiency in hospital

作　　者：李梦斐 吴越[1] 姜桦[1] 徐丛剑[1] 武欣[1] 苏毓 陆添骏 易曼莉 吴志勇[1] Li Mengfei;Wu Yue;Jiang Hua;Xu Congjian;Wu Xin;Su Yu;Lu Tianjun;Yi Manli;Wu Zhiyong(Obsterics and Gynecology Hospital of Fudan University,Shanghai 200011,China)

机构地区：[1]复旦大学附属妇产科医院,上海200011

出　　处：《中华医院管理杂志》2020年第2期127-130,共4页Chinese Journal of Hospital Administration

摘　　要：目的以某妇产科医院为例,研究单床效率评价模型及其应用,为医院床位管理提供参考和借鉴。方法通过访谈确定样本病区和关键指标,根据医院信息系统中的患者资料构建两级数据库。采用K中心聚类法,将床位按其年均空置天数(x)、年均周转次数(y)及年人均CMI(z)进行归类。以x,y,z为界限,构建三维8象限床位效率评价模型。通过比较组内均值点Ak(xk,yk,zk)较总体均值点A0(x,y,z)的偏移情况分析单床效率特征。并通过将床号对应到所属诊疗组,逐一分析各诊疗组的床位效率情况。结果根据利用效率,36张床位分布于模型的4个不同象限中。50%(18/36)的床位得到了较好的利用,28%(10/36)的床位患者收治量尚有提升空间,19%(7/36)的床位资源浪费较明显。各诊疗组间的床位效率存在明显差异。结论本研究的床位效率模型可以从病区总体及诊疗组两个层面对床位效率进行评价,实现对相关问题的深入挖掘。该模型主要适用于床位由固定诊疗组或医生负责的情况,并可通过调整和扩展,满足医院不同的战略需要。Objective To build a three-dimensional evaluation model of single bed efficiency in an obstetrics and gynecology hospital and provide reference for bed management in hospital.Methods The sample ward and key indicators were determined through interviews.A two-level database was built according to patients′data from hospital information system.K-means cluster analysis was used to get the beds classified by annual average vacancy(x),annual average turnover(y)and annual average case-mix index per capita(z).The authors built the three-dimensional bed efficiency model with x,y,z as boundaries and analyzed the bed efficiency by comparing the within group average point Ak(xk,yk,zk)with the overall average point A0(x,y,z).Whereafter the bed efficiency of each medical work team was analyzed.Results Thirty-six beds were classified into 4 categories according to utilization efficiency.50%of the beds(18 beds)were well used,28%(10 beds)had room for improvement,and 19%(7 beds)may have resource waste.Significant differences existed in bed efficiency among medical work teams.Conclusions The model in our study can realize in-depth exploration by evaluating bed efficiency from two aspects of the whole ward and each medical work team.This model,which is mainly applicable to the situation where beds are under the charge of fixed medical work groups or doctors,can be adjusted and extended to meet different strategic needs of hospitals.

关 键 词：医院管理 床位管理 K中心聚类法 欧几里得距离 

分 类 号：R197[医药卫生—卫生事业管理]