基于激励相容理论的三级综合医院日间手术管理实践  

Practice of daytime surgery management at a tertiary general hospital based on the incentive compatibility theory

作　　者：李思华 陈武朝 陆泳卓 伍春兰 樊小峰 Li Sihua;Chen Wuzhao;Lu Yongzhuo;Wu Chunlan;Fan Xiaofeng(Institute of Hospital Management and Medical Prevention Collaborative Innovation,Guangxi Academy of Medical Sciences,Nanning 530021,China)

机构地区：[1]广西医学科学院医院管理与医防协同创新研究所,南宁530021

出　　处：《中华医院管理杂志》2023年第11期821-825,共5页Chinese Journal of Hospital Administration

基　　金：国家自然科学基金(72164036);广西自然科学基金青年基金项目(2022JJB140674);广西壮族自治区卫生健康委员会科研课题(Z-A20220186)。

摘　　要：在国家三级公立医院绩效考核和按疾病诊断相关分组付费改革的背景下, 如何提升日间手术管理效能成为医院管理者关注的热点。2020年7月, 某三级甲等综合医院运用激励相容理论, 通过构建组织管理体系、给予日间手术团队增加绩效奖励、设立先进集体和个人、召开工作协调推进会、制定处罚工作方案、强化对手术质量与安全指标监管等措施, 引导医务人员自觉努力实现医院日间手术数量与质量双提升的管理目标。医院日间手术开展率、开展日间手术的科室数量、覆盖的病种数量和住院患者满意度分别从2019年的6.94%、6个科室、64个病种和90.5%增加至2022年的24.08%、21个科室、125个病种和95.0%;日间手术出血发生率和15 d再入院率从2019年的0.6%和0.5%降至2022年的0.5%和0.2%。激励相容理论契合我国日间手术发展目标, 为因地制宜提升日间手术管理效能提供了优选策略。Under the background of performance evaluation in nationwide tertiary public hospitals and the DRGs reform,how to improve the efficiency of daytime surgery management is becoming a hotspot for hospital managers.Since July 2020,a tertiary general hospital applied the theory of incentive compatibility to guide the medical workers to consciously strive to achieve such management goals as improving the quantity and quality of daytime surgeries by constructing an organizational management system,increasing performance rewards for daytime surgical teams,rewarding advanced collectives and individuals,convening work coordination and promotion meetings,formulating penalty terms,and strengthening supervision of surgical quality and safety indicators.The implementation rate of daytime surgery in hospitals,the number of departments conducting daytime surgery,the number of covered diseases,and the satisfaction rate of inpatients had increased from 6.94%,6 departments,64 diseases,and 90.5%in 2019 to 24.08%,21 departments,125 diseases,and 95.0%in 2022,respectively.The incidence of daytime surgical bleeding,and readmissions within 15 days decreased from 0.6%and 0.5%in 2019 to 0.5%and 0.2%in 2022,respectively.The theory of incentive compatibility was in line with the development goals of daytime surgery in China,providing an optimal strategy for improving the management efficiency of daytime surgery according to local conditions.

关 键 词：诊疗工作管理 医学 日间手术 激励相容理论 激励机制 约束机制 三级综合医院 

分 类 号：R197.3[医药卫生—卫生事业管理]