日间手术在分散型模式下的同质化管理实践  

Homogeneous management practice of day surgery under decentralized mode

作　　者：厉玲玲[1] 郭佳奕[1] 郑盼 储文雅[1] 徐敏慧[1] 金旎[1] 季敬伟[1] LI Lingling;GUO Jiayi;ZHENG Pan;CHU Wenya;XU Minhui;JIN Ni;JI Jingwei(Jinhua Municipal Central Hospital,No.351,Mingyue Street,Jinhua,321000,Zhejiang Province,PRC)

机构地区：[1]浙江省金华市中心医院,浙江省金华市321000

出　　处：《中国医院》2021年第3期85-87,共3页Chinese Hospitals

基　　金：浙江省医院协会研究项目(2018ZHA-ZDTQ221);金华市科学技术研究计划项目(2019-4-001)。

摘　　要：目的:探索日间手术的分散型管理模式,依托信息化临床路径等措施,建立日间手术的同质化管理。方法:通过分析推进日间手术开展的难点,借助医保政策调整、绩效机制激励,构建包括手术目录前端管理、临床路径管理、病历书写简化、后端质控的日间手术同质化管理模式,并对管理效果进行评价。结果:通过日间手术在分散型模式下的同质化管理,日间手术量增多,日间手术占比上升,住院均次费用下降、除7日内非计划再住院率以外的负性指标均得到改善。结论:分散型日间手术管理不增加医院运行成本,在同质化管理模式下,能促进日间手术开展,提升管理效率,保障医疗安全。Objective:To establish a homogeneous management mode for decentralized day surgery based on the informatization clinical pathway.Methods:Firstly,the difficulties in promoting day surgery were analyzed in detail by literature retrieval.To overcome these difficulties,a homogeneous management mode of day surgery was established by means of the adjustment of medical insurance policy and the implementation of performancebased incentive mechanism.This management mode was characterized by the front-end management of surgery directory,the clinical pathway management of day surgery,the simplification of medical record writing and the postoperative quality control.Finally,the effectiveness of the novel management mode was evaluated.Results:Since the implementation of homogeneous management,both the number and the proportion of day surgery increased,the average cost of hospitalization decreased,and the quality control indicators except the unplanned rehospitalization rate within 7 days were improved.Conclusion:Homogenization management mode can promote the management efficiency of decentralized day surgery.It improves both quantity and quality of operation while without increasing the operation cost of the hospital.

关 键 词：日间手术 分散型 同质化管理 临床路径 

分 类 号：R197.3[医药卫生—卫生事业管理]