上海市级医院日间手术运行评价与对策研究  

Evaluation and countermeasures of day surgery operation in municipal hospitals in Shanghai

作　　者：俞骏仁 沈婷[2] 成月佳 许媛媛 侯冷晨 YU Junren;SHEN Ting;CHENG Yuejia;XU Yuanyuan;HOU Lengchen(Shanghai Sixth People’s Hospital,Shanghai,200233,PRC)

机构地区：[1]上海市第六人民医院,上海市200233 [2]上海市中医医院,上海市200071 [3]上海市胸科医院,上海市200030 [4]上海市医事团体联合管理发展中心,上海市200040 [5]上海申康医院发展中心,上海市200041

出　　处：《中国医院》2023年第9期43-46,共4页Chinese Hospitals

基　　金：中国医药会计学会新苗课题(YKXKTXM2022014);上海市医院协会年度课题(X2022180);上海市医院协会青年课题(Q2022045)。

摘　　要：目的:对上海市级医院日间手术运行情况进行评价,探索基于国家公立医院考核背景下的三级医院日间手术运行对策,提升日间服务质量和效率。方法:调研上海市26所三甲医院2022年日间手术(48小时内出院)服务情况,运用秩和比法对26所医院日间手术医疗质量、效率、手术级别以及费用结构进行综合评价,结果按四档进行分类。结果:秩和比法结果提示日间手术整体运行较好的是除妇儿类以外的专科医院,其次为妇儿类医院、综合性医院和中医医院。结论:专科医院继续巩固日间手术的运行成效,综合性医院可根据医院学科特色适时调整日间手术床位,进一步增加扩充日间手术病种,提升运行质量和效率,而中医医院由于手术病种限制可适时调整对中医类医院的考核。此外,探索融合DRG支付的日间手术绩效指标推动医院高质量发展。Objective:To evaluate the operation of day surgery in Shanghai tertiary hospitals,and to explore the countermeasures of day surgery operation in tertiary hospitals under the background of national public hospital assessment,so as to improve the quality and efficiency of day service.Methods:The service status of day surgery(within 48 hours)in 26 tertiary hospitals in 2022 was investigated.The rank sum ratio(RSR)method was used to comprehensively evaluate the medical quality,efficiency,operation level,and cost structure of day surgery in 26 medical institutions.Results:The results of the rank sum ratio method showed that specialized hospitals except for women and children,followed by women and children hospitals,general hospitals,and traditional Chinese medicine hospitals had better overall operation of day surgery.Conclusion:Specialized hospitals continue to consolidate the effectiveness of day surgery.General hospitals can adjust the number of day surgery beds according to the characteristics of the hospital's disciplines,further expand the types of day surgery diseases,and improve the quality and efficiency of operation.Traditional Chinese medicine hospitals can adjust the assessment of traditional Chinese medicine hospitals due to the limitation of surgical diseases.In addition,the exploration of day surgery performance indicators integrated with DRG payment promotes the high-quality development of hospitals.

关 键 词：日间手术 运行效率 医疗质量 

分 类 号：R197.3[医药卫生—卫生事业管理]