河南省县级临床重点专科医疗服务能力发展情况分析
|
摘要
目的了解河南省2014年首批县级临床重点专科的医疗服务量和效率、医疗技术能力与质量的现状及发展情况,发现该批重点专科在医疗服务方面取得的进展以及存在的问题,推动县级临床重点专科发展,提升县级医院服务能力。方法通过问卷调查收集2011—2013年与2014—2016年数据,应用EpiData3.1进行数据录入,采用SPSS19.0软件进行配对t检验、配对秩和检验。结果河南省首批县级临床重点专科卫生服务量各项指标提升,差异有统计学意义(P <0.05);服务效率方面平均住院日下降,差异有统计学意义(P <0.05);专科特色技术项目数增加,差异有统计学意义(P <0.05);亚专科建设、临床技术、创新项目开展及应用在两个阶段变化差异无统计学意义(P> 0.05);常见病治愈率、疑难病种好转率提高,差异有统计学意义(P <0.05);医疗质量各项指标改善,差异有统计学意义(P <0.05);药占比、门诊患者抗菌药物使用比例下降,差异有统计学意义(P <0.05)。结论河南省首批县级临床重点专科卫生服务量和工作效率明显提高,常见病、疑难病种的诊疗能力提升,医疗质量显著改善,用药更加合理。应加强重点专科技术特色建设,进一步降低药占比,提升医疗卫生服务能力。
Objective To grasp the status quo and development of medical service quantity and efficiency,as well as medical technical capability and quality of the first county-level clinical key specialties in Henan Province,discover the progress and issues of medical service capacity,promote the county-level clinical key specialty,and improve the service capacity of county-level hospitals. Methods Related data was investigated and collected through questionnaire from2011 to 2013 and from 2014 to 2016. Data was entered and the database was set up by EpiData3.1,and paired t test and signed rank sum test were conducted via SPSS19.0. Results The improvement of indexes of service quantity and the decline of the average hospital stay of the first county-level clinical key specialties in Henan Province are observed(P <0.05). The increase of specialized technical projects amount is statistically significant(P < 0.05),whereas the subspecialty construction,as well as the development and application of clinical technology and innovative project are not verified(P > 0.05). The advancement of cure rate of common disease and the rate of recovery of difficult diseases is statistically significant(P < 0.05). There is improvement of indexes of medical quality,with statistically significant difference(P <0.05). Drug proportion and the proportion of antimicrobial drug use in outpatient drops,and the differences are statistically significant(P < 0.05). Conclusion The medical service quantity and quality and efficiency of the first county-level clinical key specialties in Henan Province improves significantly. The ability of diagnosis and treatment of common and difficult diseases improves. Medical quality improves significantly. And the use of drugs is more reasonable. The key technical characteristic construction should be enhanced,and drug proportion should descend continually,to elevate medical service capability.
Objective To grasp the status quo and development of medical service quantity and efficiency,as well as medical technical capability and quality of the first county-level clinical key specialties in Henan Province,discover the progress and issues of medical service capacity,promote the county-level clinical key specialty,and improve the service capacity of county-level hospitals. Methods Related data was investigated and collected through questionnaire from2011 to 2013 and from 2014 to 2016. Data was entered and the database was set up by EpiData3.1,and paired t test and signed rank sum test were conducted via SPSS19.0. Results The improvement of indexes of service quantity and the decline of the average hospital stay of the first county-level clinical key specialties in Henan Province are observed(P <0.05). The increase of specialized technical projects amount is statistically significant(P < 0.05),whereas the subspecialty construction,as well as the development and application of clinical technology and innovative project are not verified(P > 0.05). The advancement of cure rate of common disease and the rate of recovery of difficult diseases is statistically significant(P < 0.05). There is improvement of indexes of medical quality,with statistically significant difference(P <0.05). Drug proportion and the proportion of antimicrobial drug use in outpatient drops,and the differences are statistically significant(P < 0.05). Conclusion The medical service quantity and quality and efficiency of the first county-level clinical key specialties in Henan Province improves significantly. The ability of diagnosis and treatment of common and difficult diseases improves. Medical quality improves significantly. And the use of drugs is more reasonable. The key technical characteristic construction should be enhanced,and drug proportion should descend continually,to elevate medical service capability.
引文
[1]国务院.国务院办公厅印发关于县级公立医院综合改革试点意见的通知[EB/OL].(2012-06-14)[2018-09-30].http://www.gov.cn/zwgk/2012-06/14/content_2161153.htm.
[2]肖建霞,刘强,杨兵.河南省县级临床重点专科建设实践与思考[J].河南医学研究,2015(3):62-64.
[3]李金梅,冯大勇,隋虹.基于归一分析法的黑龙江省医院床位工作效率研究[J].中国医院管理,2015,35(8):47-48.
[4]国家卫生和计划生育委员会.2016中国卫生和计划生育统计年鉴[M].北京:中国协和医科大学出版社,2017.
[5]姬小荣,王禄生.我国中西部地区县医院床位规模与利用状况分析[J].中国卫生经济,2010,29(1):21-24.
[6]李丽勤,李进,林军.分级诊疗背景下发挥医院区域功能的思考[J].中国医院管理,2016,36(1):8-9.
[7]胡丽,杜光.托管模式下医院学科建设策略讨论[J].中国医院管理,2017,37(4):66-67.
[8]陈阳,程雪莲,何中臣,等.《医疗质量管理办法》的亮点与局限[J].中国医院管理,2017,37(2):27-29.
[9]张武军,李礼安,陈旻湖,等.建设临床重点专科提升医院核心竞争力的实践[J].现代医院管理,2013,11(5):5-7.
[10]喻丹,董婷,钱招昕.以专科化改革促进医院战略发展:中南大学湘雅医院学科建设实践[J].中国医院,2017,21(10):46-49.
[11]刘洪青.福建省县级综合医院医疗服务能力评价及影响因素分析[D].福州:福建医科大学,2016.
[12]邬静艳,杨泉森.浙江省县级公立医院服务能力现状及评价研究[J].中国医院,2016,20(2):8-13.
[13]苟正先.成都市县级医院临床重点专科评估指标体系研究[D].重庆:重庆医科大学,2014.
[14]黄哲,李惠.医疗机构合理用药评价模型的构建研究[J].中国医院管理,2016,36(7):67-70.
[15]陶秀德.基层医疗机构药事管理与合理用药现状及应对思考[J].中国卫生标准管理,2017,8(12):86-88.
[16]黄哲,李惠.医疗机构合理用药评价模型的构建研究[J].中国医院管理,2016,36(7):67-70.
[17]李士臻,计立群,宁岩,等.辽宁省县级公立医院改革对医院收入和服务影响分析[J].中国医院管理,2017,37(6):8-10.
[18]刘懿婕,张俊廷.国家临床重点专科文化建设的探索与实践[J].中国医院管理,2016,36(8):71-72.
[19]潘杰,张东航,王海峰,等.国家临床重点专科建设项目绩效管理的探索与思考[J].中国医院管理,2015,35(6):59-60.
[2]肖建霞,刘强,杨兵.河南省县级临床重点专科建设实践与思考[J].河南医学研究,2015(3):62-64.
[3]李金梅,冯大勇,隋虹.基于归一分析法的黑龙江省医院床位工作效率研究[J].中国医院管理,2015,35(8):47-48.
[4]国家卫生和计划生育委员会.2016中国卫生和计划生育统计年鉴[M].北京:中国协和医科大学出版社,2017.
[5]姬小荣,王禄生.我国中西部地区县医院床位规模与利用状况分析[J].中国卫生经济,2010,29(1):21-24.
[6]李丽勤,李进,林军.分级诊疗背景下发挥医院区域功能的思考[J].中国医院管理,2016,36(1):8-9.
[7]胡丽,杜光.托管模式下医院学科建设策略讨论[J].中国医院管理,2017,37(4):66-67.
[8]陈阳,程雪莲,何中臣,等.《医疗质量管理办法》的亮点与局限[J].中国医院管理,2017,37(2):27-29.
[9]张武军,李礼安,陈旻湖,等.建设临床重点专科提升医院核心竞争力的实践[J].现代医院管理,2013,11(5):5-7.
[10]喻丹,董婷,钱招昕.以专科化改革促进医院战略发展:中南大学湘雅医院学科建设实践[J].中国医院,2017,21(10):46-49.
[11]刘洪青.福建省县级综合医院医疗服务能力评价及影响因素分析[D].福州:福建医科大学,2016.
[12]邬静艳,杨泉森.浙江省县级公立医院服务能力现状及评价研究[J].中国医院,2016,20(2):8-13.
[13]苟正先.成都市县级医院临床重点专科评估指标体系研究[D].重庆:重庆医科大学,2014.
[14]黄哲,李惠.医疗机构合理用药评价模型的构建研究[J].中国医院管理,2016,36(7):67-70.
[15]陶秀德.基层医疗机构药事管理与合理用药现状及应对思考[J].中国卫生标准管理,2017,8(12):86-88.
[16]黄哲,李惠.医疗机构合理用药评价模型的构建研究[J].中国医院管理,2016,36(7):67-70.
[17]李士臻,计立群,宁岩,等.辽宁省县级公立医院改革对医院收入和服务影响分析[J].中国医院管理,2017,37(6):8-10.
[18]刘懿婕,张俊廷.国家临床重点专科文化建设的探索与实践[J].中国医院管理,2016,36(8):71-72.
[19]潘杰,张东航,王海峰,等.国家临床重点专科建设项目绩效管理的探索与思考[J].中国医院管理,2015,35(6):59-60.