【摘要】：隨著醫(yī)療技術(shù)的發(fā)展,高值醫(yī)用耗材的需求量不斷擴大、生產(chǎn)廠商與日俱增,加之高值醫(yī)用耗材多為植入性醫(yī)用耗材,選擇高值醫(yī)用耗材的恰當(dāng)與否直接關(guān)系到患者的生命健康安全,這為醫(yī)院選擇恰當(dāng)?shù)母咧滇t(yī)用耗材增加了難度。加強高值醫(yī)用耗材的準(zhǔn)入管理、構(gòu)建高值醫(yī)用耗材準(zhǔn)入的指標(biāo)體系,對于醫(yī)院,有利于滿足臨床科室需要,為臨床提供安全、有效、質(zhì)優(yōu)的醫(yī)用耗材,也有利于提高醫(yī)院管理部門對高值醫(yī)用耗材的管理水平,規(guī)范高值醫(yī)用耗材準(zhǔn)入,促進醫(yī)院可持續(xù)發(fā)展。對于患者,有助于保障患者的生命健康安全,為患者遴選出為自己適用的高值醫(yī)用耗材。本研究在研讀大量國內(nèi)外相關(guān)文獻的基礎(chǔ)上,通過專家訪談,按照科學(xué)性、整體性、可行性、定量與定性相結(jié)合、獨立性原則,自擬高值醫(yī)用耗材準(zhǔn)入指標(biāo)體系。首先,通過三輪專家咨詢,對指標(biāo)體系進行修改、矯正,最終確定了高值醫(yī)用耗材準(zhǔn)入指標(biāo)體系。其次,運用層次分析法確定指標(biāo)體系中各指標(biāo)權(quán)重并進行一致性檢驗。最后,通過實例,選取5家不同生產(chǎn)廠商的同類高值醫(yī)用耗材,按照本研究構(gòu)建的高值醫(yī)用耗材準(zhǔn)入指標(biāo)體系對醫(yī)用耗材進行評價,以驗證本研究所構(gòu)建的指標(biāo)體系的實際應(yīng)用性。本研究利用自擬的調(diào)查問卷,對專家進行預(yù)調(diào)研后,對調(diào)查問卷的信度和效度進行檢驗。經(jīng)檢驗,指標(biāo)體系總的克朗巴哈系數(shù)以及一級指標(biāo)的該系數(shù)均在0.8以上,且具有較好的表面效度和內(nèi)容效度。經(jīng)過三輪專家咨詢后,對參與調(diào)研專家的積極系數(shù)、權(quán)威程度和協(xié)調(diào)系數(shù)進行計算,結(jié)果表明,專家的積極性高且具有較好的權(quán)威性和意見一致性。對調(diào)研所收集的數(shù)據(jù)利用平均值、標(biāo)準(zhǔn)差、變異系數(shù)三種統(tǒng)計指標(biāo)進行統(tǒng)計分析,第三輪專家咨詢過后,各指標(biāo)評分平均值均在4.03以上且變異系數(shù)均小于0.19,專家意見趨于一致,不再進行第四輪專家咨詢,最終確立高值醫(yī)用耗材準(zhǔn)入的指標(biāo)體系,共包含一級指標(biāo)4個,二級指標(biāo)8個,三級指標(biāo)26個。運用層次分析法確定指標(biāo)體系中各指標(biāo)權(quán)重并進行一致性檢驗,CR值均小于0.1,指標(biāo)一致性可以接受。對最終構(gòu)建的高值醫(yī)用耗材準(zhǔn)入指標(biāo)體系通過實例應(yīng)用,證明該指標(biāo)體系具有一定的實用性。本研究從質(zhì)量維度、需求維度、經(jīng)濟維度、供應(yīng)維度共4個維度,構(gòu)建了科學(xué)、有效的高值醫(yī)用耗材準(zhǔn)入指標(biāo)體系,并具有一定的實用性。該研究對于醫(yī)院臨床科室選擇適宜高值醫(yī)用耗材具有一定參考價值,有利于提高醫(yī)院管理部門的管理水平,促進醫(yī)院的健康發(fā)展。
[Abstract]:With the development of medical technology, the demand for high-value medical consumables is expanding, and the manufacturers are increasing. In addition, high-value medical consumables are mostly implanted medical consumables. The choice of high value medical consumables is directly related to the health and safety of patients, which makes it more difficult for hospitals to choose appropriate high value medical consumables. Strengthening the access management of high value medical consumables and constructing the index system of high value medical consumables can meet the needs of clinical departments and provide safe, effective and high quality medical consumables for hospitals. It is also helpful to improve the management level of high value medical consumables, standardize the access of high value medical consumables, and promote the sustainable development of hospitals. For patients, it is helpful to ensure the health and safety of patients, and select high value medical consumables for patients. Based on the study of a large number of domestic and foreign literature, through expert interviews, according to the scientific, integrity, feasibility, quantitative and qualitative combination, independence principle, self-developed high value medical consumables access index system. First, through three rounds of expert consultation, the index system is modified, corrected, and the access index system of high value medical consumables is finally determined. Secondly, Analytic hierarchy process (AHP) is used to determine the index weights in the index system and to verify the consistency. Finally, through an example, 5 different manufacturers of the same high value medical consumables are selected to evaluate the medical consumables according to the access index system of the high value medical consumables established in this study. In order to verify the practical application of the index system. In this study, the self-designed questionnaire was used to test the reliability and validity of the questionnaire. The results showed that the total Krombaha coefficient and the first-order index coefficient of the index system were above 0.8, and had good surface validity and content validity. After three rounds of expert consultation, the positive coefficient, authority degree and coordination coefficient of the experts involved in the research are calculated. The results show that the experts are highly motivated and have good authority and consistency of opinions. After the third round of expert consultation, the average score of each index is above 4.03 and the coefficient of variation is less than 0.19. The fourth round of expert consultation was not carried out, and the index system of access to high value medical consumables was finally established, which included 4 first-grade indexes, 8 second-level indexes and 26 third-level indexes. The weight of each index in the index system is determined by analytic hierarchy process (AHP), and the CR value is less than 0.1, so the index consistency is acceptable. Through the application of a practical example, it is proved that the index system has some practicability for the final construction of the high value medical consumable material access index system. This study from the quality dimension, demand dimension, economic dimension, supply dimension altogether 4 dimensions, has constructed the scientific, the effective high value medical consumable material admittance index system, and has the certain practicability. This study has certain reference value for selecting suitable high value medical consumables in clinical departments of hospitals, which is helpful to improve the management level of hospital management departments and promote the healthy development of hospitals.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R197.32

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