某三级甲等医院妇科实施主诊医师负责制的实践探索  

Implementation of the attending physician responsibility system in the gynecology department of a tertiary hospital

作　　者：解伟 梁余良 侯娜莉 Xie Wei;Liang Yuliang;Hou Nali(Zaozhuang Municipal Hospital,Jining Medical College,Zaozhuang 277101,Shandong Province,China)

机构地区：[1]济宁医学院附属枣庄市立医院,山东省枣庄市277101

出　　处：《中国医疗管理科学》2024年第4期92-96,共5页Chinese Journal Of Medical Management Sciences

摘　　要：主诊医师负责制在国内某些医院已有实施,但尚未形成统一的运行模式。分析现有主诊医师负责制存在的问题和制约因素,然后以某三级甲等医院妇科为例,根据问题制定并实施了以科主任统一管理为前提、以细分三级学科为基础、明确主诊医师职责、加强年轻医师培养、配套实施绩效分配改革、营造积极的改革氛围等改进措施,取得了较好的效果,包括门诊人次数、出院人次数、手术台次数、医疗收入、医务性收入环比增长,投诉数量、手术并发症发生例数明显下降,非计划重返手术室再手术率、Ⅰ类切口感染率均为0。在总结经验的基础上,医院今后将进一步引导学科、主诊组和医师主动优化业务和收支结构,控制医疗成本不合理增长,以提升学科高质量发展能力。While the attending physician responsibility system has been adopted in some Chinese hospitals,no standardized operational mode has been established.This paper analyzes the existing problems and constraints of the attending physician responsibility system.A gynecology department in a tertiary hospital has attempted to address these issues by unified leadership under department chief,refined level-3 discipline division,clearly-defined role of attendant physician,enhanced training of young physicians,performance reform,and a supportive reform environment.These measures have resulted in increased patient volume,discharges,operations,and revenue and reduced complaints and surgical complications.Notably,both the unplanned reoperation rate and the incidence of surgical site infection(SSI)at class 1 wounds were both 0.In the future,the hospital will further guide different departments,diagnostic groups,and physicians to actively optimize their business and revenue/expenditure structure and control the unreasonable growth of medical costs,thus promoting the high-quality development of disciplines.

关 键 词：主诊医师负责制 三级学科 绩效改革 高质量发展 

分 类 号：R197[医药卫生—卫生事业管理]