基于TOPSIS法分析新冠肺炎疫情前后医院医疗水平  

An analysis of the medical service level before and after the COVID-19 pandemic based on TOPSIS

作　　者：高晴 王皓 王宾[3] 王慧英[1] GAO Qing;WANG Hao;WANG Bin;WANG Huiying(Medical Affairs Department,Beijing Friendship Hospital Affiliated to Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院,北京100050 [2]首都医科大学附属北京友谊医院临床流行病学与循证医学研究室,北京100050 [3]首都医科大学附属北京友谊医院平谷医院,北京101200

出　　处：《现代医院》2023年第4期558-560,567,共4页Modern Hospitals

基　　金：北京市社会科学基金项目(18GLC073)。

摘　　要：目的本研究旨在分析新冠疫情前后医院医疗指标的变化,从而评价医院疫情防控体系的实际临床价值和新冠疫情对医院医疗水平的影响。方法收集2018年12月—2020年11月某三甲医院疫情前后的医疗质量、医疗安全、医疗效率3个维度的9个指标,采用TOPSIS法综合分析不同临床科室的医疗水平变化。结果在严格疫情防控的同时,医院床位使用率由疫情前的96.56%下降至疫情后的69.66%(P<0.001);住院例均费用由疫情前的1.81万元上升至疫情后的1.82万元(P=0.016)。病例组合指数、临床路径管理率、外科科室的四级手术比例、30天再入院率、平均住院日、抗菌药物使用率、死亡率在疫情爆发前后两年间的差异没有统计学意义(P>0.05)。使用TOPSIS法对各临床科室医疗水平进行综合分析发现,综合医疗水平排名前5的内科科室在疫情后依旧排名前5,综合医疗水平排名前5的外科科室在疫情后仍有4个科室排名在前5名,仅排名顺序略有变化。结论医院疫情防控体系的设立未降低医院整体医疗水平,达到了医院一手抓疫情防控、一手抓医疗水平的总目标。Objective This study aims to analyze the changes of hospital medical indicators before and after the COVID-19 epidemic and attempts to evaluate the actual clinical value of the hospital epidemic prevention and control system and the impact of the COVID-19 epidemic on the hospital medical level.Methods Nine indicators of three domains,including medical service quality,medical service safety and medical service efficiency,were collected from a tertiary hospital from December 2018 to November 2020.TOPSIS method was used to comprehensively evaluate the medical service performance of different clinical department.Results With the strict prevention strategy of COVID-19 pandemic,the hospital occupancy rate decreased from 96.56%before the pandemic to 69.66%after the pandemic(P<0.001).The average cost of hospitalization increased from 18,100 RMB before the pandemic to 18,200 RMB after the pandemic(P=0.016).There was no statistical difference observed in the case mix index,clinical pathway management rate,the proportion of fourth level surgeries in the surgical department,the 30-days readmission rate,the average days of hospitalization,the utility rate of antibacterial drugs,and the mortality rate before and after the pandemic(P>0.05).TOPSIS analysis found that the top 5 internal clinical departments with better medical service level were still in top 5 after the pandemic.Four of the top 5 surgical departments with better medical service level were still in top 5 after the pandemic.Conclusion The hospital’s pandemic prevention strategy did not impact the medical service level of the hospital.The overall objective of the hospital,which is to focus on both pandemic prevention and medical service performance,is achieved.

关 键 词：医疗水平 TOPSIS法 新冠疫情 

分 类 号：R197[医药卫生—卫生事业管理]