西藏自治区县级综合医院服务能力评价指标体系研究

发布时间：2018-05-19 05:02

  本文选题：服务能力 + 西藏县级医院　； 参考：《北京中医药大学》2017年硕士论文

【摘要】：背景:西藏和平解放60多年,医疗服务体系取得了翻天覆地的变化,县级医院医疗服务能力得到很大的提升,但和内地县级医院相比,仍存在很大的差距。中央第六次西藏工作座谈会对西藏医疗服务能力提出了更高要求,其中县级医院医疗服务能力的提升是必不可少的一部分。目前西藏自治区县级医院基本没有分科,加上缺乏检验、麻醉等医技人员,只有少数县人民医院能开展下腹部手术,远不能满足居民的卫生服务需求,因此需要根据县级医院服务能力现状,构建一套适用于西藏自治区县级医院的评价指标体系,对县级医院的服务能力进行激励和约束,促进服务能力的提升。目的:本研究旨在通过定量与定性研究方法的综合运用,构建适合西藏县级综合医院服务能力评价指标体系,并运用指标体系对医院进行服务能力评价,促进服务能力提升。方法:采用文献分析法、焦点组访谈和专家咨询法确定评价指标体系,运用模糊数学综合评判法确定指标权重。内容:以系统管理理论和UNDP能力评价模型为导向,基于文献研究、焦点组访谈与专家咨询法,确定评价指标,采用Fuzzy综合评判法计算各指标权重,最终确定指标体系。结果:(1)德尔菲专家咨询法选择了熟悉西藏县级医院服务能力情况的27位专家,第一轮专家积极系数100%,第二轮专家积极系数88.89%,一级指标的权威程度均≥0.82。(2)通过专家咨询等方法确定的指标体系包括基础设施、人力资源、诊疗科目、医疗服务、医疗管理和经济管理共6个一级指标、12个二级指标和58个三级指标。(3)根据专家对于指标重要性、可操作性和敏感性三者的打分情况,计算出权重中的隶属度,应用模糊数学综合评价计算指标权重,一级指标权重为基础设施0.171179、人力资源0.162567、诊疗科目0.165230、医疗服务0.173903、医疗管理0.170197、经济管 0.156926。结论:(1)从基础设施、人力资源、诊疗科目、医疗服务、医疗管理和经济管理6个方面构建的指标体系合理、可行。(2)本研究遴选的专家具有代表性,选择方法适宜西藏实际情况,指标筛选合理。(3)在专家评分的基础上,运用模糊数学综合评价法计算指标权重,方法可行,结果可信。
[Abstract]:Background: more than 60 years after the peaceful liberation of Tibet, the medical service system has made tremendous changes, and the medical service capacity of county-level hospitals has been greatly improved, but there is still a big gap compared with the county-level hospitals in the mainland. The sixth Tibet work Symposium of the Central Committee has put forward higher requirements for the medical service capacity of Tibet, and the upgrading of the medical service capacity of county-level hospitals is an essential part. At present, there are basically no departments in the county hospitals of the Tibet Autonomous region. In addition to the lack of medical technicians such as testing and anesthesia, only a few county people's hospitals can perform lower abdominal surgery, which is far from meeting the health service needs of the residents. Therefore, it is necessary to construct a set of evaluation index system suitable for county hospitals in Tibet Autonomous region according to the present situation of service capacity of county-level hospitals, to motivate and restrain the service capacity of county-level hospitals, and to promote the promotion of service capacity. Objective: the purpose of this study is to establish an evaluation index system for the service capacity of Tibet county-level general hospitals through the comprehensive application of quantitative and qualitative research methods, and to use the index system to evaluate the service capacity of hospitals to promote the promotion of service capacity. Methods: literature analysis, focus group interview and expert consultation were used to determine the evaluation index system, and fuzzy mathematics comprehensive evaluation method was used to determine the index weight. Content: based on the theory of system management and the evaluation model of UNDP ability, based on literature research, focus group interview and expert consultation, the evaluation index is determined, and the weight of each index is calculated by Fuzzy comprehensive evaluation method, and the index system is finally determined. Results the Delphi expert consultation method selected 27 experts who were familiar with the service capacity of hospitals at the county level in Tibet. The first round of expert positive coefficient 100, the second round expert positive coefficient 88.89, the primary index authority degree 鈮，

本文编号：1908810