临床护理管理者对疾病诊断相关分组预付费制度改革管理体验的质性研究  

A qualitative study on clinical nursing managers′management experience of diagnosis-related groups-prepaid payment system

作　　者：马倩[1] 蒋玲[2] 毛辰蓉 Ma Qian;Jiang Ling;Mao Chenrong(Department of Gynecology,Suzhou Municipal Hospital,Suzhou 215000,China;Nursing Department,Suzhou Municipal Hospital,Suzhou 215000,China)

机构地区：[1]苏州市立医院妇科,苏州215000 [2]苏州市立医院护理部,苏州215000

出　　处：《中国实用护理杂志》2022年第26期2044-2049,共6页Chinese Journal of Practical Nursing

基　　金：苏州市护理学会姑苏护理人才"青苗"计划(SHQM202109)。

摘　　要：目的了解临床护理管理者对开展以疾病诊断相关分组为付费基础的定额预付款制度(DRGs-PPS)改革的管理体验,为疾病诊断相关分组的推行提供参考依据。方法采用现象学研究法,对15名临床护理管理者进行半结构式深度访谈,采用Colaizzi 7步分析法对访谈资料进行分析。结果共提炼出4个主题:改革带来的积极体验、护理工作的价值体现、疾病诊断相关分组推行中护理管理的促进因素及阻碍因素。结论临床护理管理者在DRGs-PPS管理过程中,有积极体验也有困扰体验,需不断提高医护人员的认知,发挥护理价值,借助第三方的搭建平台,优化人力资源配置,加强耗材管理,促进护理质量与成本的有效融合及有效监督,进而促进"疾病诊断相关分组预付费支付改革"的良性发展。Objective To explore the management experience of clinical nursing managers and to provide reference for the implementation of the reform of DRGs-PPS.Methods 15 clinical nursing managers were surveyed in an in-depth semi-structured interview by phenomenological research methods,and the data were analyzed by Colaizzi 7 analysis method.Results Four themes were extracted:the positive effect of the reform,the value reflection of nursing work,the promotion and obstacles of nursing management during DRGS implementation.Conclusions Clinical nursing managers,there are positive experience as well as negative experience for the implementation of the reform of DRGs-PPS,so we need to constantly improve the staff′s cognition,to maximize the value of nursing,draw support from policy guidance and third-party building platforms,optimizes the allocation of human resources,strengthen the management of consumables,promote nursing quality and cost effective integration and effective supervision,and promote healthy development of the DRGs-PPS.

关 键 词：定性研究 护理管理 疾病诊断相关分组 预付费制度 

分 类 号：R47[医药卫生—护理学]