荆州市晚期血吸虫病救治绩效评价

发布时间：2018-01-01 10:20

本文关键词：荆州市晚期血吸虫病救治绩效评价　出处：《华中科技大学》2011年硕士论文　论文类型：学位论文

【摘要】：研究目的本研究从医疗服务的供方和需方两个角度,对湖北省荆州市8家晚血救治定点医院晚血救治工作投入-产出效率、晚血患者住院费用及其影响因素、晚血患者生命质量等进行综合评价,对晚血救治的效果和效益进行总体评价,发现晚血救治工作中的问题,从而为完善晚血救治相关政策、优化有限卫生资源配置、提高晚血救治效益提供科学依据。研究内容本研究从医疗服务供方角度进行晚血救治绩效评价的主要内容包括:1)荆州市晚血救治定点医院基本情况,了解荆州市晚血救治8家定点医院的规模、性质、晚血工作投入的人、财、物以及2006-2008年3年间其晚血救治工作的情况;2)荆州市晚血救治定点医院投入-产出效率评估,了解荆州市晚血救治定点医院的晚血救治资源配置效率,并对其进行3年的时间序列分析以了解各医院的配置效率的变化趋势;3)晚血救治定点医院晚血患者住院费用,全面分析晚血患者住院费用的构成情况,识别住院费用的可控制和不可控制的影响因素。从医疗服务需方角度进行晚血救治绩效评价的主要内容有:1)接受救治后晚血患者生命质量的现状;2)晚血患者对晚血救治医疗机构的满意度评价;3)晚血患者接受救治后的生产、生活、生命质量的变化及其对晚血救治政策实施的感受和评价。研究方法本研究主要采用文献研究、现场调查等方法收集相关信息和数据,应用Epidata3.02、SPSS17.0和Deap2.1等软件,运用描述性分析、数据包络分析及多因素分析和新灰色关联法对荆州市8家晚血救治定点医院2006-2008共3年的晚血救治工作情况、投入-产出效率、晚血患者住院费用的构成及影响因素等进行综合分析,并结合EQ-5D生命质量量表和定性访谈对晚血患者接受救治后的生命质量进行评价。研究结果 1)有七家医院设置专门用于晚血病人救治的床位,其平均晚血救治专用床位数占总床位数的比例为72.7%。荆州市2008年晚血病人住院诊治的专项补助拨款比2006年增长了15.0%,2008年救治晚血病例数比2006年增长了3.68%。 2)2006-2008年荆州市8家晚血救治定点医院投入-产出效率总体有效的医院分别为4家、4家、3家,纯技术效率的平均值为分别为95.3%、89.9%、92.7%。 3)晚血患者次均住院费用为4662.69元,影响住院费用可控因素有药费、住院天数、治疗费、检查费;非可控因素有并发症、手术治疗、脾切史、疫情类别。 4)接受救治后晚血患者生命质量平均得分为0.743,其对自身的活动能力、自我照顾能力、日常活动能力及焦虑沮丧的评价较好,满意率分别为69.1%、60.0%、60.0%、63.6%,而对疼痛和不适的评价较差,满意率仅为36.4%,晚血患者对晚血救治医疗机构8个方面的满意率7项指标达到70.0%以上。结论与建议根据上述调查结果,本研究提出以下几点结论和建议:1)荆州市晚血救治医疗资源利用效率较高,应针对数据包络分析量化结果加强改善;2)晚血救治政策补助标准适宜,应多渠道多手段优化有限卫生资源配置,提高资源利用效率;3)加强合理用药管理,适度控制药品费用;4)合理选择检查治疗方案,最大程度发挥各项检查治疗手段的作用;5)缩短住院天数,提高医疗质量;6)加大晚血普查工作力度,引导患者合理及时就医;7)晚血患者生命质量和满意度较高,仍有提升空间,应积极改善就医环境,完善其出院后的后续管理工作。
[Abstract]:research objective
This study from two aspects of medical service supplier and demander, the output efficiency of hospital treatment work late blood input treatment to the Jingzhou City, Hubei province 8 late night blood, the blood of patients with hospitalization expenditure and its affecting factors, comprehensive evaluation of the quality of life of patients with advanced schistosomiasis, evaluating the effect and benefit of late blood treatment that night, the blood treatment problem in the work, and related policies in order to improve the treatment of late blood, optimize the allocation of limited health resources and provide a scientific basis for improving the treatment of late blood benefits.
research contents
The main contents of this study are late treatment blood performance evaluation from medical service supplier perspective include: 1) Jingzhou city night blood treatment basic understanding of Jingzhou city hospitals, 8 hospitals and blood late treatment scale, nature, TREATMFNT of job involvement, money, and 2006-2008 3 years later the blood treatment work; 2) Jingzhou City night blood treatment hospitals input-output efficiency evaluation, understand Jingzhou city night blood treatment hospitals in the late blood treatment efficiency of resource allocation, and the variation trend analysis of time series of 3 years for the hospital to know the allocation efficiency; 3) late blood treatment in designated hospitals the blood of the patients with late fees, a comprehensive analysis of the composition of blood late hospitalization expenses of patients, identify the factors influencing control and can not control the hospitalization expenses. From the perspective of the main contents of medical service performance evaluation of the late blood treatment are: 1) After receiving the treatment, the quality of life of the late blood patients was reviewed. 2) the satisfaction degree of the late blood patients to the medical institutions for late blood treatment was evaluated; 3) the changes of the production, life and quality of life after the treatment of the late blood patients and their feelings and evaluation on the implementation of the late blood treatment policy.
research method
This research mainly uses the literature research, field investigation and other methods to collect relevant information and data, the application of Epidata3.02, SPSS17.0 and Deap2.1 software, using descriptive analysis, data envelopment analysis and multi factor analysis and grey correlation method for blood treatment of late designated hospitals 2006-2008 a total of 3 years of Jingzhou city 8 home late blood. The input-output efficiency of hospitalized patients with late blood composition and influencing factors of the cost of the comprehensive analysis, combined with the quality of life of EQ-5D and evaluate the quality of life of qualitative interviews after receiving treatment in patients with late.
Research results
1) there are seven hospitals set up specifically for treatment of advanced schistosomiasis beds, the average night blood treatment special grant special beds accounted for the total bed number ratio of 72.7%. in Jingzhou city in 2008 late patients hospitalized more than 15% growth in 2006, the number of cases in late 2008 for treatment of blood than in 2006 an increase of 3.68%.
2) in 2006-2008 years, 8 inpatients with late blood treatment designated hospitals in Jingzhou had input output efficiency of 4, 4, 3, and the average of pure technical efficiency was 95.3%, 89.9%, 92.7%. respectively.
3) the average hospitalization cost of late blood patients is 4662.69 yuan. The factors influencing hospitalization expenses include drug fees, hospitalization days, treatment fees and examination fees. There are complications of non controllable factors, surgical treatment, splenic cutting history and epidemic types.
4) receiving treatment after the quality of life of patients with late the average score was 0.743, for its own ability, self-care ability, ability of daily activities and anxiety and depression evaluation is good, the satisfaction rate were 69.1%, 60%, 60%, 63.6%, and the discomfort of pain and evaluation of the poor, the satisfaction rate was only 36.4%, to the satisfaction of the 8 aspects of medical treatment of patients with late night blood rate of 7 index reached more than 70%.
Conclusions and suggestions
According to the above findings, this study gives the following conclusions and recommendations: 1) higher efficiency of utilization of medical resources in the city of Jingzhou night blood treatment, according to data envelopment analysis to quantify the results of improvement; 2) late blood treatment policy subsidy standards should be appropriate, optimizing the allocation of limited health resources with multi channels and means to improve the efficiency of resource utilization; 3) to strengthen the management of rational drug use, moderate drug cost control; 4) reasonable examination treatment, maximize the inspection treatment effect; 5) shortening hospitalization time, improve the quality of medical care; 6) increase TREATMFNT census efforts to guide the patient and reasonable timely medical treatment; 7) late life quality and satisfaction of patients with blood high, there is still room for improvement, we should actively improve the medical environment, improve the follow-up management of the hospital.

【学位授予单位】：华中科技大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R532.21;R184

【参考文献】