基于结直肠癌患者医生治疗质量指标评价

发布时间：2018-02-27 23:35

本文关键词： 结直肠癌治疗质量潜变量模型综合评价　出处：《中国公共卫生》2017年06期 　论文类型：期刊论文

【摘要】：目的通过单指标使用率及多指标综合得分进行医生结直肠癌治疗质量评价,为结直肠癌治疗质量的改善及医生的绩效考核提供依据。方法收集哈尔滨市四家医院内出院时间为2011年6月-2013年6月的结直肠癌患者病历信息共1 559份;利用适合使用某评价指标的患者数为分母,适合该指标中实际使用的患者数为分子,计算某评价指标的使用率;利用潜变量模型及贝叶斯参数估计方法,整合多维评价指标,获得医生结直肠癌治疗质量的综合得分。结果不同医生对评价指标的使用率之间存在较大的差异,术前检查生化指标、肾功能、胸部X线使用率的变异范围为3.9%~97.8%,病理报告中记录检出淋巴结数和阳性淋巴结数使用率的变异范围为95.9%~100.0%;根据潜变量模型计算的综合质量得分,医生的综合质量得分最高为xita[12]=0.405 7,即该医生的治疗质量最好;其次为xita[1]=0.3875;最低为xita[3]=-0.596 7。结论整合多维评价指标获得综合质量得分,可以多角度全面地对医生治疗质量进行综合评价;计算单指标使用率,可以在综合评价的基础上得到医生对各评价指标的使用情况。
[Abstract]:Objective to evaluate the treatment quality of colorectal cancer by single index utilization rate and multiple index comprehensive score. Methods 1 559 medical records of patients with colorectal cancer who were discharged from four hospitals from June 2011 to June 2013 were collected. By using the number of patients suitable for a certain evaluation index as denominator and the number of patients suitable for actual use as molecules, the utilization rate of an evaluation index is calculated, and the multi-dimensional evaluation index is integrated by using latent variable model and Bayesian parameter estimation method. Results there were significant differences in the utilization rate of the evaluation indexes among different doctors. The biochemical indexes and renal function were examined before operation. The variation range of chest X-ray utilization rate was 3.9% and 97.8%. The variation range of lymph node number and positive lymph node number utilization rate recorded in pathological report was 95.9% 100.0.The comprehensive mass score was calculated according to latent variable model. The highest comprehensive quality score of the doctor is xita [12] 0.405,7, that is, the doctor has the best treatment quality, the second is xita [1] 0.3875, the lowest is xita [3] -0.5967.Conclusion the comprehensive quality score can be obtained by integrating the multi-dimensional evaluation index, and the comprehensive evaluation of the doctor's treatment quality can be made from many angles. On the basis of comprehensive evaluation, the doctor's use of each evaluation index can be obtained by calculating the utilization rate of single indicator.
【作者单位】：哈尔滨医科大学公共卫生学院卫生统计学教研室;
【基金】：国家自然科学基金(81273183)
【分类号】：R197.3;R735.34

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