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作 者:熊昌娥 彭欣怡 王洪元 XIONG Chang'e;PENG Xinyi;WANG Hongyuan(School of Public Health,Wuhan University of Science and Technology,Wuhan,Hubei Province,430065,PRC)
机构地区:[1]武汉科技大学公共卫生学院,湖北省武汉市430065 [2]武汉科技大学卫生政策跨学科研究中心,湖北省武汉市430065 [3]武汉科技大学医学院,湖北省武汉市430065
出 处:《中国医院》2024年第12期16-22,共7页Chinese Hospitals
基 金:教育部人文社会科学研究规划基金(23YJAZH166);国家自然科学基金(71503075)。
摘 要:目的:分析重大传染病疫情下医疗救治资源短缺的成因,识别关键风险因素,为制定针对性的医疗救治资源应急管理策略提供理论支持。方法:利用模糊故障树分析法,建立重大传染病疫情下医疗救治资源短缺的故障树模型;基于模糊理论,计算基本事件的发生概率、结构重要度、概率重要度和相对概率重要度,中间事件和顶事件的发生概率,评估事件对医疗救治资源短缺的影响程度。结果:构建了以重大传染病疫情下医疗救治资源短缺为顶事件,医疗系统因素、人群因素、政府因素、社会因素等14个因素为中间事件,29个子因素为基本事件的故障树模型;顶事件(T)的发生概率为21.48%,医护人员自身感染(X2)、医疗救治资源需求量短时激增(X6)和患者分流机制不合理(X7)是发生概率、概率重要度和临界重要度数值均排在前3位的基本事件,且都属于中间事件医疗系统因素(Y1)。结论:医疗系统因素(Y1)是导致医疗救治资源短缺的最重要中间事件,避免医护人员自身感染、制定医疗救治资源需求量短时激增预案和建立合理的患者分流机制是应对医疗救治资源短缺的重要措施。Objective:To analyze the causes of medical resource shortages during major infectious disease epidemics and identify key risk factors,providing theoretical support for developing targeted emergency management strategies for medical resources.Methods:A fault tree model for medical resource shortages during major epidemics was constructed using the fuzzy fault tree analysis method.Based on fuzzy theory,probabilities of basic events,structural importance,probability importance,relative probability importance,and the probabilities of intermediate and top events were calculated to assess their impact on medical resource shortages.Results:A fault tree model was established with medical resource shortages during major epidemics as the top event,14 intermediate events including medical system,population,government,and social factors,and 29 basic events.The probability of the top event(T)was 21.48%.Key basic events with the highest values for probability,probability importance,and critical importance were healthcare workers’self-infection(X2),short-term surge in demand for medical resources(X6),and inadequate patient diversion mechanisms(X7),all of which belong to the medical system factor(Y1)as an intermediate event.Conclusion:The medical system factor(Y1)is the most critical intermediate event leading to medical resource shortages.Preventing healthcare worker infections,creating contingency plans for short-term surges in resource demand,and establishing effective patient diversion mechanisms are essential measures to mitigate resource shortages.
分 类 号:R197.3[医药卫生—卫生事业管理]
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