主诊医师负责制对医疗效率的影响研究  

Research on the influence of Attending Physician Accountability System on medical efficiency

作　　者：任在方[1] 张秀伟[1] 张春瑜[1] 张严兮 冯丽[1] 井玲[1] 徐培越 丁晶宏[3] REN Zaifang;ZHANG Xiuwei;ZHANG Chunyu;ZHANG Yanxi;FENG Li;JING Ling;XU Peiyue;DING Jinghong(China-Japan Friendship Hospital,No.2,Yinghuayuan East Street,Chaoyang District,Beijing,100029,PRC)

机构地区：[1]中日友好医院,北京市朝阳区100029 [2]清华大学医院管理研究院,广东省深圳市518055 [3]中日友好医院党委,北京市朝阳区100029

出　　处：《中国医院》2021年第1期80-81,共2页Chinese Hospitals

摘　　要：目的:评价中日友好医院主诊医师负责制实施前后对医疗效率的变化情况。方法:从医院HIS系统中提取平均住院日、入院患者数、床位使用率的相关数据,运用间断时间序列分析,剔除自然成长因素的影响后,比较各效率指标在主诊医师负责制实施前后的差异及变化趋势。结果:间断时间序列模型分析结果显示,实施主诊医师负责制后,医院平均住院日显著缩短(P=0.015)、出院患者数量显著增加(P=0.005)、床位周转率增加但并不显著(P=0.881)。结论:主诊医师负责制通过绩效考核机制和诊疗小组模式,提高了医务人员的工作积极性,同时下放医师权利和责任,增加了医疗服务的灵活性,有效提升了医疗效率。Objective:To evaluate the changes in medical efficiency before and after the implementation of the attending physician responsibility system in the China-Japan Friendship Hospital.Methods:Extract the relevant data of average hospitalization days,number of hospitalized patients,and bed utilization rate from the hospital HIS system,use intermittent time series analysis to eliminate the influence of natural growth factors,and compare the efficiency indicators before and after the implementation of the attending physician responsibility system Differences and trends.Results:The results of the discontinuous time series model analysis showed that after the implementation of the attending physician responsibility system,the average hospital stay was significantly shortened(P=0.015),the number of discharged patients increased significantly(P=0.005),and the bed turnover rate increased but not significantly(P=0.881).Conclusion:The attending physician responsibility system improves the enthusiasm of medical staff through the performance appraisal mechanism and the diagnosis and treatment team model,and at the same time delegates the rights and responsibilities of physicians,increases the flexibility of medical services,and effectively improves medical efficiency.

关 键 词：主诊医师 负责制 医疗效率 效果评价 

分 类 号：R197[医药卫生—卫生事业管理]