连续性肾脏替代治疗在我国五地区重症医学科的效率分析  

Efficiency analysis of continuous renal replacement therapy in intensive care unit of five regions in China

作　　者：向阳 史黎炜 肖月 邱海波[3] 杨毅[3] 刘松桥[3] 邱英鹏 张莹[4] Xiang Yang;Shi Liwei;Xiao Yue;Qiu Haibo;Yang Yi;Liu Songqiao;Qiu Yingpeng;Zhang Ying(Room of Medical Record Statistics,the First Affiliated Hospital of University of Science and Technology of China,Anhui Provincial Hospital,Hefei 230000,China;China National Health Development Research Center,National Health Commission,National Center for Medicine and Health Technology Assessment,Beijing 100000,China;Jiangsu Provincial Key Laboratory of Critical Care Medicine,Department of Critical Care Medicine,Zhongda Hospital,School of Medicine,Southeast University,Nanjing 210009,China;School of Public Health,Dalian Medical University,Dalian 116000,China)

机构地区：[1]中国科学技术大学附属第一医院,安徽省立医院病案统计室,合肥230000 [2]国家卫生健康委卫生发展研究中心暨国家药品与卫生技术综合评估中心,北京100000 [3]江苏省重症医学重点实验室,东南大学附属中大医院重症医学科,南京210009 [4]大连医科大学公共卫生学院,大连116000

出　　处：《中华重症医学电子杂志》2024年第4期358-363,共6页Chinese Journal Of Critical Care & Intensive Care Medicine(Electronic Edition)

基　　金：国家卫生健康委卫生发展研究中心科研课题(CNHDRC-KJ-L-2020-30)

摘　　要：目的测算我国医疗机构ICU连续性肾脏替代治疗(CRRT)效率并分析其影响因素,为国内进一步推进规范CRRT服务,提高各地医疗机构ICU的CRRT服务效率提供参考依据。方法收集2021年3月1日至31日我国东、中、西部5个省份,126家医疗机构ICU投入产出的信息,采用三阶段数据包络分析(DEA)模型和超效率模型,对ICU的CRRT效率值进行测算。结果126家医疗机构综合效率、纯技术效率和规模效率均值分别为0.300、0.506和0.598,5省综合效率排序为西部C省(0.364)>中部A省(0.345)>东部B省(0.286)>西部D省(0.213)>东部E省(0.169),医院等级对CRRT效率值表现出正向显著关系。结论我国5省样本机构ICU的CRRT总体效率水平偏低且存在地区差异,应优化医院内控运营管理,建立CRRT资源配置标准,创新并规范人力资源管理与培训机制,跨学科合作开展CRRT。Objective To measure the efficiency of continuous renal replacement therapy technology(CRRT)in intensive care units(ICUs)in Chinese medical institutions and analyze the influencing factors,to provide a reference for further standard CRRT services in China and improving the efficiency of ICU in local medical institutions.Methods The ICU input-output information of 126 medical institutions in five provinces of China from March 1 to 31,2021 was collected.The three-stage data envelope analysis(DEA)model and super efficiency model were used to measure the CRRT efficiency of ICU.Results The average comprehensive efficiency,pure technical efficiency and scale efficiency of the 126 medical institutions were 0.300,0.506 and 0.598,respectively.The comprehensive efficiency of the five provinces was C(0.364)>A(0.345)>B(0.286)>D(0.213)>E(0.169),and the hospital grade showed a positive and significant relationship with the efficiency of CRRT.Conclusion The overall efficiency level of CRRT in ICUs of sample institutions in five provinces is low with regional differences.It is necessary to optimize hospital internal control operation management,establish CRRT resource allocation standards,innovate and standardize human resource management and training mechanisms,and carry out CRRT through interdisciplinary cooperation.

关 键 词：连续性肾脏替代治疗 重症医学科 效率 三阶段数据包络分析 超效率 

分 类 号：R459.7[医药卫生—急诊医学]