本文選題：醫(yī)改　切入點(diǎn)：運(yùn)營效率　出處：《安徽醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的本研究通過選取安徽省某軍隊(duì)醫(yī)院作為研究對(duì)象,對(duì)2014年5到2016年4月底該醫(yī)院的運(yùn)營數(shù)據(jù)進(jìn)行收集整理,從經(jīng)濟(jì)效益、工作負(fù)荷、治療質(zhì)量、工作效率和患者負(fù)擔(dān)五個(gè)方面,分析該軍隊(duì)醫(yī)院在醫(yī)改前后運(yùn)營方面存在的問題及其產(chǎn)生的原因,同時(shí)以獨(dú)立科室為單位利用主成分加權(quán)TOPSIS法,對(duì)科室的運(yùn)營情況進(jìn)行綜合評(píng)估后,對(duì)學(xué)科的發(fā)展提出針對(duì)性意見,以期在同等規(guī)模的軍隊(duì)或者地方醫(yī)院中實(shí)現(xiàn)示范效應(yīng)。方法通過對(duì)主題詞進(jìn)行相關(guān)文獻(xiàn)的檢索,梳理軍隊(duì)醫(yī)院區(qū)別于地方醫(yī)院的發(fā)展特點(diǎn),并結(jié)合實(shí)際情況通過專家訪談和小組討論的形式,對(duì)該軍隊(duì)醫(yī)院2014-2016年共24個(gè)月的運(yùn)營數(shù)據(jù)進(jìn)行定性分析,同時(shí)通過描述性和分析性的統(tǒng)計(jì)方法對(duì)相關(guān)資料進(jìn)行定量分析。結(jié)果(1)通過采樣醫(yī)院的運(yùn)營數(shù)據(jù)來看,實(shí)行結(jié)構(gòu)性調(diào)價(jià)后對(duì)總體運(yùn)營影響較小,醫(yī)療收入雖增長(zhǎng)趨緩,但基本能夠?qū)崿F(xiàn)醫(yī)改期間平穩(wěn)過渡(2)取消藥品加成基本實(shí)現(xiàn)讓利于患者,但在高值耗材的管控方面,部分醫(yī)護(hù)人員有把趨利的重點(diǎn)從藥品轉(zhuǎn)移到了耗材上,從對(duì)照期的數(shù)據(jù)來看耗材臨床使用方面并沒有出現(xiàn)明顯的變化。(3)診療技術(shù)部分費(fèi)用上漲能夠突顯醫(yī)護(hù)人員醫(yī)療主體地位,體現(xiàn)勞動(dòng)價(jià)值,調(diào)動(dòng)工作的積極性。結(jié)論(1)雖然該醫(yī)院在醫(yī)改實(shí)行至今基本能夠?qū)崿F(xiàn)運(yùn)營上的平穩(wěn),但整體收益增幅趨緩,這提示醫(yī)院的管理者一方面在醫(yī)院建設(shè)總體上把握公益性回歸的同時(shí),要合理控制醫(yī)院發(fā)展規(guī)模。(2)在新醫(yī)改的實(shí)施的過程中,不難看出醫(yī)護(hù)人員醫(yī)療技術(shù)的價(jià)值將會(huì)是醫(yī)院運(yùn)營新的增長(zhǎng)點(diǎn),醫(yī)院應(yīng)該以技術(shù)為導(dǎo)向,在培養(yǎng)醫(yī)院技術(shù)人才的同時(shí),以增強(qiáng)科技核心競(jìng)爭(zhēng)力為主要出發(fā)點(diǎn)。(3)軍隊(duì)醫(yī)院更應(yīng)該在新階段的醫(yī)改中認(rèn)清軍隊(duì)的特殊使命和普遍的社會(huì)責(zé)任,從群眾的角度積極探索公益性的內(nèi)在目標(biāo)。(4)軍隊(duì)醫(yī)院圍繞軍地融合發(fā)展的目標(biāo),通過與地方醫(yī)院學(xué)習(xí)交流,針對(duì)醫(yī)院各個(gè)環(huán)節(jié)和經(jīng)營過程再造管理流程,在全員培養(yǎng)風(fēng)險(xiǎn)管理文化氛圍,樹立風(fēng)險(xiǎn)意識(shí),建立并健全多角度風(fēng)險(xiǎn)管理體系。
[Abstract]:Objective this study selected a military hospital in Anhui Province as the research object, collected and sorted the operation data of the hospital from 2014 to the end of April 2016, from economic benefits, workload, treatment quality. This paper analyzes the problems existing in the operation of the military hospital before and after the medical reform and the reasons for its occurrence in five aspects of work efficiency and patient burden. Meanwhile, the principal component weighted TOPSIS method is used in the independent department as the unit. After the comprehensive evaluation of the operation of the department, the author puts forward some suggestions on the development of the subject, in order to realize the demonstration effect in the army or the local hospital of the same scale. Combing the development characteristics of military hospital and local hospital, and combining the actual situation with the form of expert interview and group discussion, this paper makes a qualitative analysis of the 24-month operation data of the military hospital from 2014-2016. At the same time, through descriptive and analytical statistical methods, the relevant data are quantitatively analyzed. Results: according to the operating data of the hospitals, the effect of structural price adjustment on the overall operation is relatively small, and the growth of medical revenue has slowed down. However, it is basically possible to achieve a smooth transition during the medical reform period. (2) canceling the drug addition basically makes the patient benefit. However, in the control of high-value consumables, some medical and nursing personnel have shifted the focus of profit seeking from drugs to consumables. According to the data of the control period, there is no obvious change in the clinical use of consumables. (3) the increase in the cost of diagnosis and treatment technology can highlight the status of medical personnel as the main body of medical treatment and reflect the value of labor. Conclusion 1) although the hospital has been able to operate smoothly until now, the overall income increase has slowed down. This suggests that, on the one hand, hospital managers should grasp the return of public welfare on the whole in hospital construction, and at the same time, they should reasonably control the scale of hospital development. (2) in the process of implementation of the new medical reform, It is not difficult to see that the value of medical technology for medical personnel will be a new growth point in hospital operation. Hospitals should be technology-oriented and at the same time train technical personnel in hospitals. In order to enhance the core competitiveness of science and technology as the main starting point, military hospitals should recognize the special mission and universal social responsibility of the army in the new stage of medical reform. From the perspective of the masses, we actively explore the intrinsic goal of public welfare. (4) the military hospital revolves around the goal of integration between the army and the local government, through learning and communicating with the local hospital, reengineering the management process for each link and operation process of the hospital, Cultivate the culture atmosphere of risk management, set up risk consciousness, establish and perfect multi-angle risk management system.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R82

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