基于结构方程模型的日间手术向日归手术发展的影响因素分析  

Influencing factor analysis of day surgery developing towards same-day surgery based on structural equation modeling

作　　者：庄磊雪[1] 杨建超 李志超[3] 马洪升[3] ZHUANG Leixue;YANG Jianchao;LI Zhichao;MA Hongsheng(International Medical Center,West China Hospital,Sichuan University,Chengdu,Sichuan 610041,P.R.China;Business School,Hohai University,Nanjing,Jiangsu 211100,P.R.China;Day Surgery Center,West China Hospital,Sichuan University,Chengdu,Sichuan 610041,P.R.China)

机构地区：[1]四川大学华西医院特需病房,成都610041 [2]河海大学商学院,南京211100 [3]四川大学华西医院日间手术中心,成都610041

出　　处：《华西医学》2022年第2期182-188,共7页West China Medical Journal

基　　金：国家自然科学基金(71804118,71804117)。

摘　　要：目的探析影响日间手术向日归手术发展的因素,为促进日归手术发展提供参考。方法基于结构方程模型编制日归手术影响因素问卷,共包括6个维度、23个条目。2021年1月-10月,于四川大学华西医院日间手术中心,采用偶遇抽样法抽取研究对象进行问卷调查,通过结构方程模型分析日间手术向日归手术服务模式迭代升级发展的影响因素。结果共发放问卷200份,回收有效问卷192份,有效回收率96.0%。调查问卷的Cronbachα系数为0.857,各维度Cronbachα系数为0.832~0.934;KMO检验值为0.822,Bartlett球度检验结果为χ2=4568.330,P<0.001。模型拟合指数分析显示各项指标适配度良好。结构方程模型结果显示,"日间手术向日归手术转变后为医院带来的发展"影响"手术质量与安全保障相关制度建设"的标准路径系数值的绝对值<0.3;"医院为日间手术向日归手术发展的前期准备"影响"手术质量与安全保障相关制度建设"、"手术质量与安全保障相关制度建设"影响"民众对日间手术向日归手术发展的认知程度"、"手术质量与安全保障相关制度建设"影响"‘医院-社区’一体化协作网络发展"、"民众对日间手术向日归手术发展的认知程度"影响"‘医院-社区’一体化协作网络发展"、"‘医院-社区’一体化协作网络发展"影响"日间手术向日归手术发展的效果"的标准路径系数均>0.5,表明这些因素间有较强的影响效果。结论医院的前期准备、手术质量与安全相关保障制度、"医院-社区"一体化协作网络发展、民众对日归手术的认知程度可能是日间手术向日归手术迭代升级发展的影响因素。Objective To analyze the factors influencing day surgery developing towards same-day surgery,and provide a reference for the promotion of same-day surgery.Methods A questionnaire on influencing factors of sameday surgery was prepared based on structural equation modeling(SEM),including 6 dimensions and 23 items.From January to October 2021,at the Day Surgery Center of West China Hospital,Sichuan University,the random sampling method was used to select the research subjects for a questionnaire survey,and SEM was used to analyze the factors impacting the iterative development of day surgery to same-day surgery service model.Results A total of 200 questionnaires were distributed,and 192 valid questionnaires were recovered,with an effective recovery rate of 96.0%.The Cronbach’sαcoefficient of the questionnaire was 0.857,and the Cronbach’sαcoefficient of each dimension was from 0.832 to 0.934.The KMO test value was 0.822,and the result of Bartlett sphericity test wasχ2=4568.330,P<0.001.The model fit indexes met the standard requirements well.The result of SEM revealed that the standard path coefficients of“the hospital’s preliminary preparation for day surgery developing towards same-day surgery”impacting“the guarantee system related to surgical quality and safety”,“the guarantee system related to surgical quality and safety”impacting“the public’s awareness of day surgery developing towards same-day surgery”,“the guarantee system related to surgical quality and safety”impacting“the‘hospital-community’integrated collaboration network”,“the public’s awareness of day surgery developing towards same-day surgery”impacting“the‘hospital-community’integrated collaboration network”,and“the‘hospital-community’integrated collaboration network”impacting“the iterative upgrade of day surgery”were all larger than 0.5,indicating strong influences between these factors,but the absolute value of standard path coefficient of the“hospital’s development brought by the tr

关 键 词：日间手术 日归手术 影响因素 结构方程模型 

分 类 号：R197.323[医药卫生—卫生事业管理]