应用Delphi法构建疑难危重症患者评价体系  

Application of the delphi method in the construction of the evaluation system for patients with difficult and critical illness

作　　者：马立旭[1] 张彦杰[1] 徐建虎[2] 梁沛枫[1] MA Lixu;ZHANG Yanjie;XU Jianhu;LIANG Peifeng(People’s Hospital of Ningxia Hui Autonomous Region,Yinchuan 750002,China;Ningxia Medical University,Yinchuan 750004,China)

机构地区：[1]宁夏回族自治区人民医院,宁夏银川750002 [2]宁夏医科大学,宁夏银川750004

出　　处：《现代医院》2022年第3期393-396,400,共5页Modern Hospitals

基　　金：宁夏自然科学基金(2018AAC03272);宁夏重点研发计划项目(2019BEG03011)。

摘　　要：目的利用Delphi法构建疑难危重症患者评价体系,并将其应用到疑难危重率(CD率)等绩效指标计算中,引导临床科室收治疑难危重患者,以期达到国家对三级公立医院的功能定位。方法课题组查阅大量文献基础上,采用Delphi法,选取30位临床专家进行两轮专家咨询,分析并确定最终疑难危重评价指标体系。结果专家平均年龄40.57岁,平均工作年限为15.43年,硕士研究生占73.33%,副高职称占83.33%,涉及骨科、妇产科、儿科等多个临床专业领域。两轮问卷的有效回收率分别是80%和100%,专家权威系数均为0.79,协调系数分别为0.222、0.298,差异有统计学意义(χ^(2)=339.321,P<0.001)。最终确定4个维度31条指标。结论该研究专家的积极性较高,权威性和协调性较好,所构建的指标体系合理可靠,为三级公立医院计算CD率并应用于绩效考核提供技术支持。Objective The Delphi method is used to construct an evaluation system for patients with difficult and critical illnesses,and it is applied to the calculation of performance indicators such as the difficult and critical illness rate(CD rate),and the clinical department is guided to admit and treat difficult and critically ill patients,in order to achieve the functional positioning of the state for tertiary public hospitals.Methods On the basis of consulting large number of documents,the research team used the Delphi method,selected 30 clinical experts for two rounds of expert consultation,analyzed and determined the final evaluation index system of critical patients.Results The average age of experts is 40.57 years old,and the average working years are 15.43 years.Master degree account for 73.33%,and associate chief physician account for 83.33%,involving orthopedics,obstetrics and gynecology,pediatrics and other clinical fields of expertise.The effective recovery rates of the two rounds of questionnaires were 80% and 100%;the expert authority coefficient was 0.79;the coordination coefficient was 0.222 and 0.298(χ^(2)=339.321,P<0.001).Finally,31 indicators of 4 dimensions were established.Conclusion The research experts are highly motivated,authoritative and well-coordinated,the index system constructed is reasonable and reliable,which provides technical support for Tertiary public hospitals to calculate CD rate and apply it to performance appraisal.

关 键 词：疑难危重症患者 DELPHI法 评价体系 CD率 

分 类 号：R197.3[医药卫生—卫生事业管理]