高值医用耗材准入的指标体系构建研究

发布时间：2018-09-12 16:15

【摘要】：随着医疗技术的发展,高值医用耗材的需求量不断扩大、生产厂商与日俱增,加之高值医用耗材多为植入性医用耗材,选择高值医用耗材的恰当与否直接关系到患者的生命健康安全,这为医院选择恰当的高值医用耗材增加了难度。加强高值医用耗材的准入管理、构建高值医用耗材准入的指标体系,对于医院,有利于满足临床科室需要,为临床提供安全、有效、质优的医用耗材,也有利于提高医院管理部门对高值医用耗材的管理水平,规范高值医用耗材准入,促进医院可持续发展。对于患者,有助于保障患者的生命健康安全,为患者遴选出为自己适用的高值医用耗材。本研究在研读大量国内外相关文献的基础上,通过专家访谈,按照科学性、整体性、可行性、定量与定性相结合、独立性原则,自拟高值医用耗材准入指标体系。首先,通过三轮专家咨询,对指标体系进行修改、矫正,最终确定了高值医用耗材准入指标体系。其次,运用层次分析法确定指标体系中各指标权重并进行一致性检验。最后,通过实例,选取5家不同生产厂商的同类高值医用耗材,按照本研究构建的高值医用耗材准入指标体系对医用耗材进行评价,以验证本研究所构建的指标体系的实际应用性。本研究利用自拟的调查问卷,对专家进行预调研后,对调查问卷的信度和效度进行检验。经检验,指标体系总的克朗巴哈系数以及一级指标的该系数均在0.8以上,且具有较好的表面效度和内容效度。经过三轮专家咨询后,对参与调研专家的积极系数、权威程度和协调系数进行计算,结果表明,专家的积极性高且具有较好的权威性和意见一致性。对调研所收集的数据利用平均值、标准差、变异系数三种统计指标进行统计分析,第三轮专家咨询过后,各指标评分平均值均在4.03以上且变异系数均小于0.19,专家意见趋于一致,不再进行第四轮专家咨询,最终确立高值医用耗材准入的指标体系,共包含一级指标4个,二级指标8个,三级指标26个。运用层次分析法确定指标体系中各指标权重并进行一致性检验,CR值均小于0.1,指标一致性可以接受。对最终构建的高值医用耗材准入指标体系通过实例应用,证明该指标体系具有一定的实用性。本研究从质量维度、需求维度、经济维度、供应维度共4个维度,构建了科学、有效的高值医用耗材准入指标体系,并具有一定的实用性。该研究对于医院临床科室选择适宜高值医用耗材具有一定参考价值,有利于提高医院管理部门的管理水平,促进医院的健康发展。
[Abstract]:With the development of medical technology, the demand for high-value medical consumables is expanding, and the manufacturers are increasing. In addition, high-value medical consumables are mostly implanted medical consumables. The choice of high value medical consumables is directly related to the health and safety of patients, which makes it more difficult for hospitals to choose appropriate high value medical consumables. Strengthening the access management of high value medical consumables and constructing the index system of high value medical consumables can meet the needs of clinical departments and provide safe, effective and high quality medical consumables for hospitals. It is also helpful to improve the management level of high value medical consumables, standardize the access of high value medical consumables, and promote the sustainable development of hospitals. For patients, it is helpful to ensure the health and safety of patients, and select high value medical consumables for patients. Based on the study of a large number of domestic and foreign literature, through expert interviews, according to the scientific, integrity, feasibility, quantitative and qualitative combination, independence principle, self-developed high value medical consumables access index system. First, through three rounds of expert consultation, the index system is modified, corrected, and the access index system of high value medical consumables is finally determined. Secondly, Analytic hierarchy process (AHP) is used to determine the index weights in the index system and to verify the consistency. Finally, through an example, 5 different manufacturers of the same high value medical consumables are selected to evaluate the medical consumables according to the access index system of the high value medical consumables established in this study. In order to verify the practical application of the index system. In this study, the self-designed questionnaire was used to test the reliability and validity of the questionnaire. The results showed that the total Krombaha coefficient and the first-order index coefficient of the index system were above 0.8, and had good surface validity and content validity. After three rounds of expert consultation, the positive coefficient, authority degree and coordination coefficient of the experts involved in the research are calculated. The results show that the experts are highly motivated and have good authority and consistency of opinions. After the third round of expert consultation, the average score of each index is above 4.03 and the coefficient of variation is less than 0.19. The fourth round of expert consultation was not carried out, and the index system of access to high value medical consumables was finally established, which included 4 first-grade indexes, 8 second-level indexes and 26 third-level indexes. The weight of each index in the index system is determined by analytic hierarchy process (AHP), and the CR value is less than 0.1, so the index consistency is acceptable. Through the application of a practical example, it is proved that the index system has some practicability for the final construction of the high value medical consumable material access index system. This study from the quality dimension, demand dimension, economic dimension, supply dimension altogether 4 dimensions, has constructed the scientific, the effective high value medical consumable material admittance index system, and has the certain practicability. This study has certain reference value for selecting suitable high value medical consumables in clinical departments of hospitals, which is helpful to improve the management level of hospital management departments and promote the healthy development of hospitals.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R197.32

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