山东大学学报 (医学版) ›› 2025, Vol. 63 ›› Issue (6): 107-116.doi: 10.6040/j.issn.1671-7554.0.2025.0354
• 公共卫生与预防医学 • 上一篇
蔡治清1,董世菊2,李乃坤1,崔雪丹1,王建伟1,王亨3
CAI Zhiqing1, DONG Shiju2, LI Naikun1, CUI Xuedan1, WANG Jianwei1, WANG Heng3
摘要: 目的 评价山东省某三级综合医院的运营管理效能,旨在为推动公立医院高质量发展提供参考。 方法 基于文献分析法构建三级综合医院临床科室高质量发展评价指标体系,结合山东省某三级综合医院2023年1月至12月的月度运行数据,采用熵权逼近理想解排序(technique for order preference by similarity to an ideal solution, TOPSIS)法对临床科室高质量发展进行综合评价,运用Ci值判断该医院运营管理效能优劣。 结果 本研究共纳入3个一级指标和28个二级指标。TOPSIS综合分析结果显示,自2023年4月以来,Ci值明显上升,由0.435逐月上升至10月的0.534,而11月和12月Ci值呈略微下降趋势。分维度评价结果显示,该医院的服务能力、质量安全和运行效率下设的二级指标(逐步降低类指标除外)均呈明显上升趋势。 结论 该医院临床科室高质量发展整体呈向好趋势,尤其是在服务能力、质量安全和运行效率方面表现突出。
中图分类号:
| [1] 黄俊杰, 吴彦龙, 王辉宇, 等.“国考”背景下广西三级公立医院运营效率评价研究——基于DEA-Malmquist和Tobit模型[J]. 卫生经济研究, 2025, 42(2): 90-93. HUANG Junjie, WU Yanlong, WANG Huiyu, et al. Study on the evaluation of operational efficiency of tertiary public hospitals in Guangxi under the background of "national examination" —based on DEA-Malmquist and Tobit models [J]. Health Economics Research, 2025, 42(2): 90-93. [2] 余红星, 范新语, 赵欣如, 等. 公立医院高质量发展面临的问题及对策研究[J]. 中国医院, 2024, 28(1): 2-6. YU Hongxing, FAN Xinyu, ZHAO Xinru, et al. Research on problems and countermeasures faced by high-quality development of public hospitals [J]. Chinese Hospitals, 2024, 28(1): 2-6. [3] 农意扬, 张新花, 许海东, 等. 海南省三级公立医院运营效率及其影响因素[J]. 医学与社会, 2024, 37(2): 84-89. NONG Yiyang, ZHANG Xinhua, XU Haidong, et al. Operation efficiency and influencing factors of tertiary public hospitals in Hainan Province [J]. Medicine and Society, 2024, 37(2): 84-89. [4] 国家卫生健康委员会. 关于加强公立医院运营管理的指导意见(国卫财务发〔2020〕27号)[EB/OL].(2020-12-21)[2025-05-06]. https://www.gov.cn/zhengce/zhengceku/202012/26/content_5573493.htm [5] 王素贤, 郭智萍, 赵要军, 等. 我国公立医院运营管理演变历程与发展趋势研究[J]. 中国医院管理, 2025, 45(3): 15-17. WANG Suxian, GUO Zhiping, ZHAO Yaojun, et al. Research on the evolution and development trend of operation management of public hospitals in China[J]. Chinese Hospital Management, 2025, 45(3): 15-17. [6] 吴学智. 基于DRG的某院临床科室住院医疗绩效加权TOPSIS评价 [J]. 中国卫生统计, 2023, 40(5): 734-737. [7] 赵慧智, 王娟, 刘冰,等. 基于住院病案首页数据的医院医疗质量评价模型的构建及应用 [J]. 郑州大学学报(医学版), 2020, 55(3): 396-400. ZHAO Huizhi, WANG Juan, LIU Bing, et al. Construction and application of hospital medical quality evaluation model based on home page data of inpatient medical records[J]. Journal of Zhengzhou University(Medical Sciences), 2020, 55(3): 396-400. [8] Gülin Büyükzkan, Gizem ifi. A combined fuzzy AHP and fuzzy TOPSIS based strategic analysis of electronic service quality in healthcare industry[J]. Expert Syst Appl, 2012, 39(3): 2341-2354. [9] Chen P. Effects of normalization on the entropy-based TOPSIS method[J]. Expert Syst Appl, 2019, 13633-13641. doi:10.1016/J.ESWA.2019.06.035 [10] 国家卫生健康委员会. 国家卫生健康委办公厅关于印发公立医院高质量发展评价指标(试行)操作手册(2022版)的通知 [EB/OL].(2022-12-22)[2025-04-25]. http://www.nhc.gov.cn/yzygj/s3594q/202212/d5bf2e95504e43e8a1394422e524536c.shtml [11] 国家卫生健康委员会. 国家卫生健康委办公厅关于印发国家三级公立医院绩效考核操作手册(2023版)的通知 [EB/OL].(2023-02-27)[2025-04-25]. https://www.gov.cn/zhengce/zhengceku/2023-03/02/content_5744105.htm [12] 赵俊娟, 李菲. 惠民保可持续发展评价指标体系构建研究 [J]. 中国卫生事业管理, 2024, 41(9): 987-992. ZHAO Junjuan, LI Fei. Research on the construction of sustainable development evaluation indicator system of huimin insurance[J]. The Chinese Health Service Management, 2024, 41(9): 987-992. [13] 吴新飞, 廖慧群, 杨青, 等. 基于医疗质量指数及专科能力指数的科室医疗质量评价 [J]. 现代医院, 2023, 23(8): 1202-1206. WU Xinfei,LIAO Huiqun,YANG Qing, et al. Medical quality evaluation of departments based on medical quality index and specialty ability index[J]. Modern Hospitals, 2023, 23(8): 1202-1206. [14] 宋佳, 范成鑫, 艾旭峰, 等. 基于熵权-TOPSIS结合RSR法的山东省卫生资源配置地区性差异研究[J]. 现代预防医学, 2022, 49(3): 456-460. SONG Jia, FAN Chengxin, AI Xufeng, et al. Regional differences of health resource allocation based on entropy weight-TOPSIS combined with RSR method, Shandong Province [J]. Modern Preventive Medicine, 2022, 49(3): 456-460. [15] 王建伟, 王小芹, 王素珍,等. 基于TOPSIS与综合指数法的医院医疗质量综合评价 [J]. 中国病案, 2020, 21(11): 75-78. WANG Jianwei, WANG Xiaoqin, WANG Suzhen, et al. Research of hospital medical quality evaluation with TOPSIS and synthetic index methods[J]. Chinese Medical Record, 2020, 21(11): 75-78. [16] 徐斌, 韦雪, 黄夏萍. 基于熵权TOPSIS分析法的南宁市基本公共卫生服务综合评价 [J]. 实用预防医学, 2019, 26(2): 156-159. XU Bin, WEI Xue, HUANG Xiaping. Comprehensive evaluation of basic public health servicesin Nanning City based on entropy weight TOPSIS method[J]. Practical Preventive Medicine, 2019, 26(2): 156-159. [17] 李秋莎, 尹文强, 黄冬梅,等. L市社区老年人卫生服务利用情况及综合评价 [J]. 中国初级卫生保健, 2019, 33(12): 17-20. LI Qiusha, YIN Wenqiang, HUANG Dongmei, et al. Utilization of health services and comprehensive evaluation for the elderly in the communities of L City[J]. Chinese Primary Health Care, 2019, 33(12): 17-20. [18] 胡桐, 吴才波, 田昕, 等. 北京市医疗联合体分级诊疗效果及影响因素研究 [J]. 中国医院管理, 2024, 44(1): 47-52. HU Tong, WU Caibo, TIAN Xin, et al. Evaluation of hierarchical diagnosis and treatment effect and influencing factors of Beijing medical alliance[J]. Chinese Hospital Management, 2024, 44(1): 47-52. [19] 吴进, 吴琰, 方玢茹, 等. 肿瘤医院临床科室运营效益综合评价体系构建及应用 [J]. 中国医院管理, 2024, 44(8): 33-36. WU Jin, WU Yan, FANG Binru, et al. Construction and application of comprehensive evaluation system of operation benefit of clinical departments in cancer hospitals[J]. Chinese Hospital Managemen, 2024, 44(8): 33-36. [20] Reddy AS, Kumar PR, Raj PA. Entropy-based fuzzy TOPSIS framework for selection of a sustainable buildingmaterial[J]. International Journal of Construction Management, 2022, 22(7): 1194-1205. [21] 滕晓燕, 朱立峰, 赵艳. 高质量发展背景下医院运营管理信息化研究热点、演化与趋势 [J]. 中国数字医学, 2024, 19(6): 1-10. TENG Xiaoyan, ZHU Lifeng, ZHAO Yan.Research hotspots, evolution and trend of IT application in hospital operation and management in the context of high-quality development[J]. China Digital Medicine, 2024, 19(6): 1-10. [22] 宋士华, 张锦春, 熊丽萍. 医改新形势下平衡计分卡在医院绩效管理中的新作用及改进方向——以新余市中医院为例 [J]. 中国中医药现代远程教育, 2024, 22(16): 202-205. SONG Shihua, ZHANG Jinchun, XIONG Liping. The new role and improvement direction of balanced scorecard in performance management of hospitals under the new situation of medical reform hospitals under the new situation of medical reform: taking Xinyu Hospital of Traditional Chinese Medicine as an example[J]. Chinese Medicine Modern Distance Education of China, 2024, 22(16): 202-205. [23] 陈丽, 朱立燕, 倪小荣, 等. 基于数据包络分析的四川省县域医疗卫生次中心运行效率研究 [J]. 现代预防医学, 2024, 51(23): 4327-4332. CHEN Li, ZHU Liyan, NI Xiaorong et al. A study on the operational efficiency of county-level medical and health sub-centers in Sichuan Province based on data envelopment analysis[J]. Modern Preventive Medicine, 2024, 51(23): 4327-4332. [24] 李浩鑫, 王楠, 刘利, 等. 基于熵权TOPSIS法的北京市各区医疗卫生服务能力综合评价 [J]. 中国公共卫生管理, 2025, 41(1): 87-90. LI Haoxin, WANG Nan, LIU Li, et al. Comprehensive evaluation of medical service capacity in various districts of Beijing City based on entropy weight TOPSIS method[J]. Chinese Journal of Public Health Management, 2025, 41(1): 87-90. [25] 李翔, 雷思雨, 丁东. 党建引领公立医院高质量发展的体系结构与方法路径 [J]. 中国医院管理, 2025, 45(1): 25-28. LI Xiang, LEI Siyu, DING Dong. Architecture and method path of party building leading the high-quality development of public hospitals[J]. Chinese Hospital Management, 2025, 45(1): 25-28 [26] 王卉晓, 叶腾飞, 张琳. DRG支付下医院医保管理模式探讨 [J]. 卫生经济研究, 2025, 42(2): 77-80. WANG Huixiao, YE Tengfei, ZHANG Lin. Study on medical insurance management model in hospitals under DRG payment[J]. Health Economics Research, 2025, 42(2): 77-80. [27] 刘浏, 牛雅娟, 刘子裕,等. 数智病理平台构建及服务模式研究 [J/OL]. 中国工程科学,(2025-03-11)[2025-04-25]. https://link.cnki.net/urlid/11.4421.G3.20250311.0955.002.html LIU Liu, NIU Yajuan, LIU Ziyu, et al. Digital intelligence pathology platform andIts service pattern[J/OL]. Strategic Study of CAE,(2025-03-11)[2025-04-25]. https://link.cnki.net/urlid/11.4421.G3.20250311.0955.002.html [28] 王国林, 曹冬梅, 陶源, 等. DRG支付体系下病案首页编码质控逻辑与对策 [J]. 中国医院管理, 2022, 42(9): 65-67. WANG Guolin, CAO Dongmei, TAO Yuan, et al. Logic and countermeasures of quality control for coding of medical record home page under DRG pay-ment system[J]. Chinese Hospital Management, 2022, 42(9): 65-67. [29] 郑晓菊, 黄静, 廖友鑫, 等. 基于DRG病组的临床路径管理实践探索 [J]. 卫生经济研究, 2024, 41(12): 24-28. ZHENG Xiaoju, HUANG Jing, LIAO Youxin, et al. Exploration of clinical pathway management practice based on DRG disease group[J]. Health Economics Research, 2024, 41(12): 24-28. [30] 周炯, 王书畅, 马小军. 借力DRG支付模式提升医疗质量安全 [J]. 协和医学杂志, 2024, 15(5): 981-986. ZHOU Jiong, WANG Shuchang, MA Xiaojun. Improving medical quality and safety through DRG payment model[J]. Medical Journal of Peking Union Medical College Hospital, 2024, 15(5): 981-986. [31] 曾雁冰, 程瑞谦, 张国平, 等. 基于DEA方法的三级公立医院运行效率分析 [J]. 中国卫生统计, 2019, 36(6): 847-850. [32] 胡晓梅, 苏岱, 姜迪,等. 医保支付方式改革下医院运行效率评价指标体系构建研究 [J]. 中国医院, 2024, 28(4): 6-9. HU Xiaomei, SU Dai, JIANG Di, et al. Evaluation study on the construction of hospital operational efficiency evaluation index system under the reform of medical insurance payment method[J]. Chinese Hospitals, 2024, 28(4): 6-9. [33] 李向一, 王清亮, 张永媛, 等. 基于广义估计方程的某三甲医院超长住院日影响因素分析[J].山东大学学报(医学版), 2021, 59(1): 102-107. LI Xiangyi, WANG Qingliang, ZHANG Yongyuan, et al. Analysis of influencing factors of prolonged length of stay in a tertiary hospital based on generalized estimation equation[J]. Journal of Shandong University(Health Sciences), 2021, 59(1): 102-107. [34] 姜小峰, 姚静静, 朱大伟, 等. 补偿机制改革对山东省某县级公立医院住院服务的影响 [J]. 山东大学学报(医学版), 2020, 58(9): 95-102. JIANG Xiaofeng, YAO Jingjing, ZHU Dawei, et al. Influence of compensation mechanism reform on the hospitalization expenses of a county-level public hospital in Shandong Province[J]. Journal of Shandong University(Health Sciences), 2020, 58(9): 95-102. |
| [1] | 杨慧,苏士晶,李芬. 基于双向孟德尔随机化法探讨组织蛋白酶与衰弱的因果关联[J]. 山东大学学报 (医学版), 2025, 63(2): 67-76. |
| [2] | 鹿子龙, 付振涛,杜恩情,徐春晓,张吉玉,楚洁,张丙银,吴炳义,郭晓雷. 2018年山东省成人自报健康预期寿命测算研究[J]. 山东大学学报 (医学版), 2020, 1(9): 83-88. |
| [3] | 康凤玲,丁荔洁,柳晓涓,周苗,薛付忠. 多中心健康管理人群心脑血管疾病负担分析[J]. 山东大学学报 (医学版), 2017, 55(12): 51-55. |
| [4] | 苏丽娜,徐凌忠,韩开益. 山东省高血压患者服药行为影响因素的广义估计方程分析[J]. 山东大学学报 (医学版), 2017, 55(12): 66-70. |
| [5] | 王金涛,苏萍,袁中尚,薛付忠. 部分分布竞争风险模型及其在健康风险评估中的应用[J]. 山东大学学报(医学版), 2017, 55(6): 37-41. |
| [6] | 王停停,王金涛,袁中尚,苏萍,薛付忠. 原因别竞争风险模型及其在健康风险评估中的应用[J]. 山东大学学报(医学版), 2017, 55(6): 42-46. |
| [7] | 蔡远楚,王家林,张军,姚能亮,孙晓杰. 山东省5县癌症幸存者工作状况及影响因素[J]. 山东大学学报(医学版), 2017, 55(4): 96-100. |
| [8] | 公晓云,申小涛,徐静,张涛,朱正江,薛付忠. 代谢组学数据正态性对疾病分类准确性的影响[J]. 山东大学学报(医学版), 2016, 54(4): 89-93. |
| [9] | 徐静,袁中尚,薛付忠,刘言训. 基于得分检验的两整体基因间共关联作用的统计推断[J]. 山东大学学报(医学版), 2016, 54(1): 75-79. |
| [10] | 丁李路, 孙强. 我国卫生总费用影响因素通径分析[J]. 山东大学学报(医学版), 2015, 53(12): 86-89. |
| [11] | 李芳玉,袁中尚,张霄帅,薛付忠. 基于偏最小二乘路径模型的整体基因与多数量性状交互作用的统计推断[J]. 山东大学学报(医学版), 2013, 51(11): 102-106. |
| [12] | 李明1,杨华2,高倩倩1,李士雪1. 济南市失能老年人居家长期照护者负担及其影响因素分析[J]. 山东大学学报(医学版), 2013, 51(9): 109-112. |
| [13] | 吴继卫1,董茂江1,张明霞2. 德州市城镇参保职工低血压现状及与慢性病的关系[J]. 山东大学学报(医学版), 2012, 50(10): 127-129. |
| [14] | 杨爽,徐凌忠,王兴洲,邵辉,薛青云,郭振,赵伟宁,张茜,徐荣飞. 社区门诊患者对基本药物制度满意度分析[J]. 山东大学学报(医学版), 2012, 50(9): 124-. |
| [15] | 王昕1,王健2,刘言训1,贾崇奇1. 山东省3县农村居民被动吸烟情况研究[J]. 山东大学学报(医学版), 2012, 50(4): 110-. |
|
||