基于全科医生绩效考核的数据仓库模型研究

发布时间：2018-06-06 01:26

本文选题：全科医生 + 绩效考核　；参考：《山西医科大学》2017年硕士论文

【摘要】：目的:基于对全科医生绩效进行定量化考核的目标,拟定数据收集的指标体系框架,用大数据和信息化系统来解决全科医生绩效考核的问题,为全科医生绩效考核从规划走向现实架起一座桥梁,为全科医生绩效考核信息资源的有效利用提供参考。方法:通过文献计量学方法分析并界定国内全科医生绩效研究的前沿和热点领域,为指标框架的拟定提供指示;通过文献研究,查找全科医生绩效考核指标框架中的具体要素,初步设计了全科医生绩效考核指标框架;采用利益相关者分析的方法对全科医生绩效考核过程中可能的参与主体进行理论探讨,并从不同的职能角度对全科医生绩效考核利益相关团体的信息需求进行分析;采用结构-过程-结果三维质量评价模式,对初步设计的全科医生绩效考核指标框架进行评价。结果:1.全科医生绩效研究(1)国内全科医生绩效研究热点:(1)与全科医生相关的激励机制:签约服务、双向转诊、分级诊疗;(2)全科医生健康管理的研究热点:慢性病管理、糖尿病、高血压。(2)全科医生相关制度包括:“全科医生签约制服务”制度、社区首诊制和双向转诊制度、“按人头付费”制度等。(3)全科医生绩效考核指标体系框架:从医疗服务结果、医疗服务过程和医疗服务能力三个方面出发,初步构建以人群健康结果和医疗费用为导向的全科医生绩效考核指标框架,为数据仓库概念模型主题的确定与描述奠定了基础。2.全科医生绩效考核信息需求分析全科医生绩效考核的利益相关集团包括卫生行政机构、医疗卫生专业机构、医疗卫生服务提供方和医疗卫生服务需求方。从不同的职能角度对各利益相关团体的信息需求进行了具体的分析与阐述,为数据仓库模型中主题的确立奠定了基础。3.全科医生绩效考核数据仓库模型的研究(1)全科医生绩效考核数据仓库概念模型的研究:(1)根据数据仓库的主要特征和数据组织形式,结合实际情况,界定数据仓库系统边界,涉及三个子系统:社区居民、医疗服务的提供者即全科医生、全科医生制度管理方;(2)确定了主要的主题域并对其进行分析;(3)以“考核”主题为例,采用信息包图完整、规范化的对主题进行分析,建立了概念数据模型;(4)利用E-R图表示了全科医生绩效考核数据仓库的概念设计模型。(2)数据仓库逻辑模型的确定主要完成了三方面的工作:(1)分析主题,确定当前要优先装载的主题,即“考核”主题;(2)对数据仓库中数据粒度进行了划分,以“考核”主题与“医疗费用”主题为例进行阐述,确定这两个主题均采用双重粒度;(3)定义关系模式,针对全科医生绩效考核数据仓库中信息组织特点和概念模型的多维特性,采取星型模式和雪花模型来实现全科医生绩效考核数据仓库逻辑模型设计。并以考核主题、医疗费用主题、慢性病管理主题为例,来说明设计中使用的维度表,事实表,以及之间的逻辑关系。(3)全科医生绩效考核物理模型的设计主要从确定数据的存储结构、索引策略、存放位置以及数据的存储分配等方面进行了分析。总结:本研究从全科医生绩效考核业务需求的角度出发,阐述和分析了数据仓库模型的设计过程,通过概念模型、逻辑模型和物理模型构建面向主题的全科医生绩效考核数据仓库模型。该模型的建模原则和设计过程对全科医生绩效考核数据仓库的构建具有较好的参考价值,同时为全科医生绩效管理决策提供一定的理论指导。
[Abstract]:Objective: Based on the objective of quantitative assessment of the performance of the general practitioner, the framework of the index system for data collection is drawn up to solve the problem of the performance assessment of the general practitioner with large data and information system, so as to build a bridge for the performance assessment of the general practitioner from the planning to the reality, and to make effective use of the information resources of the general practitioner's performance assessment. Provide reference. Methods: through Bibliometrics method analysis and definition of the domestic general practitioner performance research frontiers and hot areas, to provide indicators for the formulation of the index framework; through literature research, find out the specific elements in the framework of general practitioner performance assessment index, initially set up a general practitioner performance evaluation index framework; adopt benefits. The method of stakeholder analysis is a theoretical study of the possible participants in the performance assessment process of the general practitioner, and analyzes the information requirements of the general practitioner's performance assessment from different functional perspectives, and uses the structure process results three-dimensional quality evaluation model to evaluate the performance evaluation index of the preliminary general practitioner. Framework evaluation. Results: 1. general practitioner performance study (1) domestic general practitioner performance research hot spots: (1) incentive mechanism related to general practitioner: signing service, two-way referral, grading diagnosis and treatment; (2) the research hotspot of general practitioner health management: chronic disease management, diabetes, hypertension. (2) general practitioner related system including: "general practitioner" Contract system service "system, community first diagnosis system and two-way referral system," pay by person "system and so on. (3) the framework of the performance assessment index system of general practitioners: from three aspects of medical service results, medical service process and medical service ability, the performance of general practitioner based on population health results and medical expenses is preliminarily constructed. The assessment index framework provides a basis for the determination and description of the theme of the conceptual model of the data warehouse, which lays the foundation for the performance assessment of the.2. general practitioner. The stakeholder groups including the health administration, the medical and health institutions, the health service providers and the medical and health service providers. A specific analysis and exposition of the information requirements of various interest related groups is carried out, and the research on the basis of the theme of the data warehouse model has been laid on the basis of the.3. general practitioner performance assessment data warehouse model (1) the research on the concept model of the general practitioner performance assessment data warehouse: (1) according to the main features and data groups of the data warehouse Weaving, combining with the actual situation, defines the boundary of the data warehouse system, involving three subsystems: community residents, medical service providers, the general practitioner, the general practitioner system manager, and (2) determining the main subject domain and analyzing it; (3) taking the "assessment" theme as an example, using the information package complete and standardized to the subject. The concept data model is established. (4) the concept design model of the GP performance assessment data warehouse is expressed by E-R diagram. (2) the determination of the data warehouse logic model is mainly completed in three aspects: (1) to analyze the theme, to determine the topic that should be first loaded, that is, the "assessment" theme, and (2) the granularity of data in the data warehouse. In this paper, the "assessment" theme and the "medical cost" theme were illustrated for example, and the two subjects were determined to use double granularity; (3) the relationship model was defined. In view of the multidimensional characteristics of the information organization characteristics and conceptual models in the general practitioner performance assessment data warehouse, the star pattern and snowflake model were adopted to achieve the general practitioner performance. Check the logic model of the data warehouse, and take the examination topic, the medical cost theme, the chronic disease management subject as an example, to explain the dimension table, the fact table and the logical relationship between the design, (3) the design of the physical model of the general practitioner's performance assessment is mainly from the storage structure, the index strategy, the location and the number of the data. According to the analysis of the storage distribution and other aspects, this paper summarizes and analyzes the design process of the data warehouse model from the perspective of the requirements of the performance assessment of the general practitioner, and constructs the data warehouse model of the subject oriented general practitioner through the concept model, logic model and physical model. And the design process has a good reference value to the construction of the general practitioner's performance appraisal data warehouse, and provides some theoretical guidance for the general practitioner's performance management decision.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R197.1

【参考文献】