基于扎根理论的北京市应用医疗优先分级调度系统的影响因素研究  

Study of influential factors of applied medical priority dispatch system in Beijing based on grounded theory

作　　者：李秀秀 雷行云 谢莉琴[1] 胡红濮[1] LI Xiu-xiu;LEI Xing-yun;XIE Li-qin(Institute of Medical Information,Chinese Academy of Medical Sciences,Peking Union Medical College,Beijing 100020,China;不详)

机构地区：[1]北京协和医学院中国医学科学院医学信息研究所,北京100020

出　　处：《中国医学装备》2022年第3期147-153,共7页China Medical Equipment

基　　金：国家社会科学基金(17BGL184)“大数据环境下分级诊疗的服务模式研究”。

摘　　要：目的:探讨北京市应用医疗优先分级调度系统(MPDS)的直接和间接影响因素,构建统一的应用MPDS影响因素模型,并据此提出针对性改进建议。方法:按照目的抽样法于2021年4-8月抽取北京市急救中心21名工作人员开展半结构化访谈,采用扎根理论研究方法对访谈资料进行开放编码、主轴编码和选择性编码的三级编码,构建北京市应用MPDS影响因素模型。结果:经过三级编码梳理出与北京市应用MPDS相关的51个概念和17个范畴,最终形成5个主范畴和1个核心范畴。确定北京市应用MPDS的影响因素及其作用机制为核心范畴,调度员因素、MPDS系统因素、呼救者因素、内部管理和外部支持为5个主范畴的北京市应用MPDS影响因素模型。结论:北京市急救中心应用MPDS过程中,调度员因素发挥引导作用,MPDS系统因素是前提条件,呼救者因素是决定性因素,内部管理发挥激励作用,外部支持发挥保障作用,需完善激励机制、大社会大急救体系建设及调度指挥系统和加强社会急救能力。Objective:To explore the direct and indirect influencing factors of applied medical priority dispatch system(MPDS) in Beijing,to construct a unified influencing factors model of MPDS application,and to put forward corresponding improving suggestions.Methods:Semi-structured interviews were conducted with 21 staff members from Beijing Emergency Medical Center selected by objective sampling method from April to August 2021.Based on the method of Grounded Theory,open coding,spindle coding and selective coding were used to construct the influencing factors model of MPDS application in Beijing.Results:Through the three-level coding,51 concepts and 17 categories related to the application of MPDS in Beijing were sorted out,5 main categories and 1 core category were formed.The influencing factors model of the application of MPDS in Beijing was determined,the influencing factors of the application of MPDS in Beijing and its mechanism of action were the core categories,and the dispatcher factor,MPDS system factor,caller factor,internal management and external support are 5 main categories.Conclusion:During the application of MPDS in Beijing Emergency Medical Center,the dispatcher factor plays a guiding role,the MPDS system factor is a precondition,the caller factor is a decisive factor,the internal management plays an incentive role,and the external support plays a guarantee role.It is necessary to improve the incentive mechanism,the great society and great first-aid system construction and dispatching and commanding system and strengthen social first-aid ability.

关 键 词：医疗优先分级调度 扎根理论 院前急救 社会急救 

分 类 号：R197.324[医药卫生—卫生事业管理]