基于国家公立医院绩效考核的医疗服务能力评价和提升策略研究  

Study on the evaluation of medical service capacity and improvement strategy based on the performance assessment of national public hospitals

作　　者：苗卫军[1] 杨永嫦 黄雪莹[1] 张敏[1] 高琪佩 李静华 龚韩湘 MIAO Weijun;YANG Yongchang;HUANG Xueying;ZHANG Min;GAO Qipei;LI Jinghua;GONG Hanxiang(The Second Affiliated Hospital of Guangzhou Medical University,Guangzhou,Guangdong Province,510260,PRC)

机构地区：[1]广州医科大学附属第二医院,广东省广州市510260 [2]广州医科大学公共卫生学院,广东省广州市511495

出　　处：《中国医院》2024年第10期6-11,共6页Chinese Hospitals

基　　金：广东省医学科研基金项目(A2023489);广州市卫生健康科技一般引导项目(20231A010050);广州医科大学2024年度科研能力提升计划项目(2024SRP246)。

摘　　要：目的:以广州市为例,评价三级公立医院医疗服务能力,提出医疗服务能力的提升策略。方法:采用熵权-TOPSIS方法和Kernel密度估计,评估2019-2021年广州市省部属、市属和区属三级公立医院的医疗服务能力。同时,运用Dagum基尼系数分析医疗服务能力的不平等程度。结果:研究显示,广州市三级公立医院在医疗服务能力上存在显著差异。省部属医院整体表现较好,市属医院正在缩小与省部属医院的差距,而区属医院面临较大挑战。基尼系数分析揭示不同级别医院之间以及同一级别内部的医疗服务能力不平等问题。结论:为提升医院服务能力,建议实施差异化策略,明确不同类型医院的功能定位,并关注内涵式发展。加强跨医院合作和知识共享,提高科学管理水平,并加大政策和资金支持,尤其是对区属医院。Objective:Taking Guangzhou City as an example,this study aims to evaluate the medical service capacity of tertiary public hospitals and propose strategies to improve medical service capacity.Methods:The entropy-weighted TOPSIS method and Kernel density estimation were employed to assess the medical service capability of provincial,municipal,and district-level tertiary public hospitals in Guangzhou from 2019 to 2021.Additionally,the Dagum Gini coefficient was applied to analyze the inequality in medical service capability.Results:The study reveals significant differences in medical service capability among tertiary public hospitals in Guangzhou.Provincial hospitals demonstrate better overall performance,municipal hospitals are narrowing the gap with provincial hospitals,while district-level hospitals face substantial challenges.The Gini coefficient analysis highlights inequalities in medical service capability both among hospitals of different levels and within the same level.Conclusion:To enhance hospital service capability,it is recommended to implement differentiated strategies,clarify the functional positioning of different types of hospitals,and emphasize intrinsic development.Strengthening inter-hospital collaboration and knowledge sharing,improving scientific management,and increasing policy and financial support,especially for district-level hospitals,are crucial.

关 键 词：三级公立医院 绩效考核 医疗服务能力 

分 类 号：R197.3[医药卫生—卫生事业管理]