某军队医院适应国家医改的运营效率评价及对策研究

发布时间：2018-03-13 00:12

本文选题：医改　切入点：运营效率　出处：《安徽医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的本研究通过选取安徽省某军队医院作为研究对象,对2014年5到2016年4月底该医院的运营数据进行收集整理,从经济效益、工作负荷、治疗质量、工作效率和患者负担五个方面,分析该军队医院在医改前后运营方面存在的问题及其产生的原因,同时以独立科室为单位利用主成分加权TOPSIS法,对科室的运营情况进行综合评估后,对学科的发展提出针对性意见,以期在同等规模的军队或者地方医院中实现示范效应。方法通过对主题词进行相关文献的检索,梳理军队医院区别于地方医院的发展特点,并结合实际情况通过专家访谈和小组讨论的形式,对该军队医院2014-2016年共24个月的运营数据进行定性分析,同时通过描述性和分析性的统计方法对相关资料进行定量分析。结果(1)通过采样医院的运营数据来看,实行结构性调价后对总体运营影响较小,医疗收入虽增长趋缓,但基本能够实现医改期间平稳过渡(2)取消药品加成基本实现让利于患者,但在高值耗材的管控方面,部分医护人员有把趋利的重点从药品转移到了耗材上,从对照期的数据来看耗材临床使用方面并没有出现明显的变化。(3)诊疗技术部分费用上涨能够突显医护人员医疗主体地位,体现劳动价值,调动工作的积极性。结论(1)虽然该医院在医改实行至今基本能够实现运营上的平稳,但整体收益增幅趋缓,这提示医院的管理者一方面在医院建设总体上把握公益性回归的同时,要合理控制医院发展规模。(2)在新医改的实施的过程中,不难看出医护人员医疗技术的价值将会是医院运营新的增长点,医院应该以技术为导向,在培养医院技术人才的同时,以增强科技核心竞争力为主要出发点。(3)军队医院更应该在新阶段的医改中认清军队的特殊使命和普遍的社会责任,从群众的角度积极探索公益性的内在目标。(4)军队医院围绕军地融合发展的目标,通过与地方医院学习交流,针对医院各个环节和经营过程再造管理流程,在全员培养风险管理文化氛围,树立风险意识,建立并健全多角度风险管理体系。
[Abstract]:Objective this study selected a military hospital in Anhui Province as the research object, collected and sorted the operation data of the hospital from 2014 to the end of April 2016, from economic benefits, workload, treatment quality. This paper analyzes the problems existing in the operation of the military hospital before and after the medical reform and the reasons for its occurrence in five aspects of work efficiency and patient burden. Meanwhile, the principal component weighted TOPSIS method is used in the independent department as the unit. After the comprehensive evaluation of the operation of the department, the author puts forward some suggestions on the development of the subject, in order to realize the demonstration effect in the army or the local hospital of the same scale. Combing the development characteristics of military hospital and local hospital, and combining the actual situation with the form of expert interview and group discussion, this paper makes a qualitative analysis of the 24-month operation data of the military hospital from 2014-2016. At the same time, through descriptive and analytical statistical methods, the relevant data are quantitatively analyzed. Results: according to the operating data of the hospitals, the effect of structural price adjustment on the overall operation is relatively small, and the growth of medical revenue has slowed down. However, it is basically possible to achieve a smooth transition during the medical reform period. (2) canceling the drug addition basically makes the patient benefit. However, in the control of high-value consumables, some medical and nursing personnel have shifted the focus of profit seeking from drugs to consumables. According to the data of the control period, there is no obvious change in the clinical use of consumables. (3) the increase in the cost of diagnosis and treatment technology can highlight the status of medical personnel as the main body of medical treatment and reflect the value of labor. Conclusion 1) although the hospital has been able to operate smoothly until now, the overall income increase has slowed down. This suggests that, on the one hand, hospital managers should grasp the return of public welfare on the whole in hospital construction, and at the same time, they should reasonably control the scale of hospital development. (2) in the process of implementation of the new medical reform, It is not difficult to see that the value of medical technology for medical personnel will be a new growth point in hospital operation. Hospitals should be technology-oriented and at the same time train technical personnel in hospitals. In order to enhance the core competitiveness of science and technology as the main starting point, military hospitals should recognize the special mission and universal social responsibility of the army in the new stage of medical reform. From the perspective of the masses, we actively explore the intrinsic goal of public welfare. (4) the military hospital revolves around the goal of integration between the army and the local government, through learning and communicating with the local hospital, reengineering the management process for each link and operation process of the hospital, Cultivate the culture atmosphere of risk management, set up risk consciousness, establish and perfect multi-angle risk management system.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R82

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