基于公立医院高质量发展的一院多区学科布局设置研究  

Study on the Setting of Discipline Layout of One Hospital and Multiple Districts Based on the High-Quality Development of Public Hospitals

作　　者：石函宁 徐道亮[1] 李小芳[1] 赵曼 周静[1] 宋慧[1] SHI Hanning;XU Daoliang;LI Xiaofang(Subei People's Hospital,Yangzhou,Jiangsu,225001,China)

机构地区：[1]苏北人民医院,江苏扬州225001

出　　处：《中国卫生质量管理》2023年第9期85-89,共5页Chinese Health Quality Management

基　　金：江苏省医院协会医院管理创新专项研究课题(编号:JSYGY-1-2021-PJ134)。

摘　　要：目的构建一院多区学科布局评价指标体系,探索适宜分院区发展的学科方向。方法运用文献分析法和德尔菲法确立评价指标体系;采用AHP-CRITIC组合赋权法计算权重系数,结合各临床科室运行数据测算科室得分;采用K-means聚类分析对科室进行分类,推选出最优学科。结果评价指标体系包含3个一级指标、10个二级指标、54个三级指标,两轮咨询专家权威系数均为0.88,协调系数分别为0.29和0.18,三级指标权重在0.005到0.065之间。得分较高的科室:妇产科(55.77分)、介入放射科(53.88分)、普外胃肠外科(53.86分)等,得分较低的科室:内分泌科(40.39分)、肾脏内科(40.35分)、临床心理科(40.28分)等。通过K-means聚类,43个临床科室分为I类科室5个(占比12%),II类科室11个(占比26%),III类科室18个(占比42%),IV类科室9个(占比21%)。结论优先推荐到分院区开展的科室包括妇产科、介入放射科、普外胃肠外科等。分院区科室布局重点考虑指南标准、科室资源使用程度、区域医疗能力提升程度、突发公共卫生事件应急能力等因素。Objective To establish an evaluation index system of disciplinary layout of one hospital and multiple districts,and to explore the discipline direction suitable for the development of branch districts.Methods Literature analysis and Delphi method were used to establish the evaluation index system.The weight coefficient was calculated by AHP-CRITIC combined weighting method,and the department score was calculated by combining the operational data of each clinical department,and the departments were classified by K-means cluster analysis,and the optimal discipline was selected for the new hospital district.Results The evaluation index system contains 3 first-level indicators,10 second-level indicators and 54 third-level indicators.The authority coefficient of the two rounds of consulting experts is 0.88,the coordination coefficient is 0.29 and 0.18,respectively,and the weights of the third-level indicators are between 0.005 and 0.065.The departments with high scores were Obstetrics and Gynecology(55.77 points),Interventional Radiology(53.88 points),General Gastrointestinal Surgery(53.86 points),etc.The departments with low scores are Endocrinology(40.39 points),Nephrology(40.35 points),Clinical Psychology(40.28 points),etc.Through K-means clustering,the 43 clinical departments were divided into 5 departments in category I(12%),11 departments in category II(26%),18 departments in category III(42%),and 9 departments in category IV(21%).Conclusion The priority departments recommended for the 7 branch hospitals included Obstetrics and Gynecology,Interventional Radiology,General Gastrointestinal Surgery,etc.The layout of branch departments should focus on the factors such as guideline standards,the degree of departmental resource use the degree of regional medical capacity enhancement and the emergency response capacity for public health emergencies.

关 键 词：高质量发展 一院多区 科室布局 评价指标体系 

分 类 号：R197.6[医药卫生—卫生事业管理] R331.1[医药卫生—公共卫生与预防医学]