基于三级公立医院绩效考核标准的手术患者并发症统计分析  

Statistics of surgical patients'complications based on performance appraisal of tertiary public hospitals

作　　者：黄俊杰 黄明智 朱敬蕊[1] 黄靖雯 HUANG Jun-jie;HUANG Ming-zhi;ZHU Jing-rui;HUANG Jing-wen(Department of Quality Management,the First Affiliated Hospital of Bengbu Medical College,Bengbu,Anhui 233004,China)

机构地区：[1]蚌埠医学院第一附属医院质量管理科,安徽蚌埠233000

出　　处：《中华全科医学》2022年第8期1423-1426,共4页Chinese Journal of General Practice

基　　金：安徽省人文社会科学研究重点项目(SK2019A0208)。

摘　　要：目的手术患者并发症发生率是衡量医院医疗技术能力和管理水平的重要结果指标之一,手术患者并发症的统计和管理是医疗质量管理的重点和难点,参考我国三级公立医院绩效考核对手术患者并发症的统计方法,通过病案首页对某三级公立医院手术患者并发症进行统计和分析。方法在提高住院病案首页质量的基础上,参照我国三级公立医院绩效考核的统计方法,利用住院病案首页统计某三级公立医院2019—2020年的手术患者并发症情况,初步分析该院手术患者并发症情况,根据统计结果确定手术患者并发症高风险科室和重点病种。结果发生例数最多的手术患者并发症是出血或血肿、手术后切口愈合不良、肺部感染,3种并发症发生数占全院手术患者并发症总数的63.29%。并发症发生例数最多的临床科室在抗菌药物使用、术后护理等方面存在缺陷。结论手术患者并发症的管理情况复杂,不同并发症发生的原因多种多样,同一种并发症发生的原因也可能存在较大差异,精确的手术操作、精细化的护理、合理用药、仪器设备的正确使用都是预防手术患者并发症的重要手段。手术患者并发症的管理是诊疗行为全过程的管理,需要信息化的支持、配套制度的有效执行、多部门的协作,需要医院医疗技术水平作为保障。针对手术患者并发症的各项干预措施也应进行评价并不断优化。Objective The complication rate of surgical patients is one of the important outcome indicators to measure the medical technical ability and management level of hospitals.The statistics and management of surgical complications are the key and difficult points of medical quality management.Referring to the statistical methods of surgical complications in the performance appraisal of three-level public hospitals in China,the complications of surgical patients are counted through the medical record homepage.Methods On the basis of improving the quality of the medical record homepage,the complications of surgical patients in a three-level public hospital from 2019 to 2020 were counted using the first page of inpatient medical records.The complications of surgical patients in the hospital were preliminarily analysed and the high-risk departments and key diseases of surgical patients were determined in accordance with the statistical results.Results The complications of surgical patients with the largest number of cases were bleeding or hematoma,poor wound healing and pulmonary infection.The number of three complications accounted for 63.29%of the total number of surgical complications in the hospital.The clinical department with the largest number of complications had defects in the use of antibiotics and postoperative nursing.Conclusion The management of complications in surgical patients is complex.The causes of different complications are diverse and great differences may exist in the causes of the same complication.Accurate surgical operation,fine nursing,rational drug use and correct use of instruments and equipment are important means to prevent complications in surgical patients.The management of surgical patients'complications is the management of the whole process of diagnosis and treatment behaviour.It needs the support of informatisation,the effective implementation of supporting systems,the cooperation of multiple departments and the level of hospital medical technology as a guarantee.The intervention meas

关 键 词：三级公立医院 绩效考核 手术患者并发症 

分 类 号：R197.323.1[医药卫生—卫生事业管理]