基于秩和比法的基层卫生院托管效果综合评价研究  

Research on the Trusteeship Effect of a Health Center based on Rank-Sum-Ratio Method

作　　者：李玉奇 张柠 吴利纳 LI Yuqi;ZHANG Ning;WU Lina(School of Public Health,Capital Medical University,BeiJing,100069,China;不详)

机构地区：[1]首都医科大学公共卫生学院,北京100069 [2]北京市大兴区人民医院,北京102600

出　　处：《中国社会医学杂志》2021年第5期558-561,共4页Chinese Journal of Social Medicine

基　　金：教育部人文社科规划基金项目(16YJAZH076);北京市社会科学基金项目(18GLA007)。

摘　　要：目的探讨基层卫生院被托管后的整体发展状况,发现托管过程中存在的问题,完善托管策略,为卫生行政和医院管理部门的医院间合作提供参考和决策。方法在研究区域内以一定的标准筛选出四家发展好且未被托管的基层卫生院为参照对象,从人才结构、工作负荷、工作效率和服务质量5个维度中选取16个研究指标,对2014年和2018年两年所有对象的指标数据用RSR法分析,利用A卫生院(2015年初被托管)托管前后的分档和排序变化评定托管效果。结果被托管后A卫生院服务能力和医疗质量相对研究参照对象提升较大,门诊诊疗人次数增长31.45%,出院人数增长34.03%,门诊处方合格率增长3.67%、住院病历合格率增长4.13%;用RSR法分析后,整体排名从第三升为第一,分档从良升为优。结论被托管后,基层卫生院医疗技术水平有显著提高,诊疗流程更规范,服务量提升较快,综合收入逐年增加。该托管模式对乡镇卫生院发展有正向促进作用。Objective By studying the development of the health centers after trusteeship,this study aimed to find the problems existing in trusteeship,improve the trusteeship strategy,and provide reference and decision-making for health administration and hospital.Methods Through certain criteria,four well-developed health centers were selected as research objects.Sixteen indicators from five dimensions of talent structure,workload,work efficiency and service quality were selected.Relative values of the indicators in 2014 and 2018 were analyzed with RSR.Trusteeship effect was evaluated according to the change of classification and ranking.Results After being entrusted,the service capacity and medical quality of health center A had been greatly improved compared with the reference objects,and the ranking and grading had increased.Conclusion After the health center A was entrusted,there is a significant improvement in medical technology with more standardized diagnosis processes.The service volume has increased and the revenue has increased year by year.This trusteeship model has played a positive role in promoting the development of the health center。

关 键 词：乡镇卫生院 医院托管 医院改革 效果评价 秩和比 

分 类 号：R197.62[医药卫生—卫生事业管理]