本文關(guān)鍵詞：荊州市晚期血吸蟲病救治績(jī)效評(píng)價(jià)　出處：《華中科技大學(xué)》2011年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 晚期血吸蟲病 績(jī)效評(píng)價(jià) 數(shù)據(jù)包絡(luò)分析

【摘要】：研究目的 本研究從醫(yī)療服務(wù)的供方和需方兩個(gè)角度,對(duì)湖北省荊州市8家晚血救治定點(diǎn)醫(yī)院晚血救治工作投入-產(chǎn)出效率、晚血患者住院費(fèi)用及其影響因素、晚血患者生命質(zhì)量等進(jìn)行綜合評(píng)價(jià),對(duì)晚血救治的效果和效益進(jìn)行總體評(píng)價(jià),發(fā)現(xiàn)晚血救治工作中的問(wèn)題,從而為完善晚血救治相關(guān)政策、優(yōu)化有限衛(wèi)生資源配置、提高晚血救治效益提供科學(xué)依據(jù)。 研究?jī)?nèi)容 本研究從醫(yī)療服務(wù)供方角度進(jìn)行晚血救治績(jī)效評(píng)價(jià)的主要內(nèi)容包括:1)荊州市晚血救治定點(diǎn)醫(yī)院基本情況,了解荊州市晚血救治8家定點(diǎn)醫(yī)院的規(guī)模、性質(zhì)、晚血工作投入的人、財(cái)、物以及2006-2008年3年間其晚血救治工作的情況;2)荊州市晚血救治定點(diǎn)醫(yī)院投入-產(chǎn)出效率評(píng)估,了解荊州市晚血救治定點(diǎn)醫(yī)院的晚血救治資源配置效率,并對(duì)其進(jìn)行3年的時(shí)間序列分析以了解各醫(yī)院的配置效率的變化趨勢(shì);3)晚血救治定點(diǎn)醫(yī)院晚血患者住院費(fèi)用,全面分析晚血患者住院費(fèi)用的構(gòu)成情況,識(shí)別住院費(fèi)用的可控制和不可控制的影響因素。從醫(yī)療服務(wù)需方角度進(jìn)行晚血救治績(jī)效評(píng)價(jià)的主要內(nèi)容有:1)接受救治后晚血患者生命質(zhì)量的現(xiàn)狀;2)晚血患者對(duì)晚血救治醫(yī)療機(jī)構(gòu)的滿意度評(píng)價(jià);3)晚血患者接受救治后的生產(chǎn)、生活、生命質(zhì)量的變化及其對(duì)晚血救治政策實(shí)施的感受和評(píng)價(jià)。 研究方法 本研究主要采用文獻(xiàn)研究、現(xiàn)場(chǎng)調(diào)查等方法收集相關(guān)信息和數(shù)據(jù),應(yīng)用Epidata3.02、SPSS17.0和Deap2.1等軟件,運(yùn)用描述性分析、數(shù)據(jù)包絡(luò)分析及多因素分析和新灰色關(guān)聯(lián)法對(duì)荊州市8家晚血救治定點(diǎn)醫(yī)院2006-2008共3年的晚血救治工作情況、投入-產(chǎn)出效率、晚血患者住院費(fèi)用的構(gòu)成及影響因素等進(jìn)行綜合分析,并結(jié)合EQ-5D生命質(zhì)量量表和定性訪談對(duì)晚血患者接受救治后的生命質(zhì)量進(jìn)行評(píng)價(jià)。 研究結(jié)果 1)有七家醫(yī)院設(shè)置專門用于晚血病人救治的床位,其平均晚血救治專用床位數(shù)占總床位數(shù)的比例為72.7%。荊州市2008年晚血病人住院診治的專項(xiàng)補(bǔ)助撥款比2006年增長(zhǎng)了15.0%,2008年救治晚血病例數(shù)比2006年增長(zhǎng)了3.68%。 2)2006-2008年荊州市8家晚血救治定點(diǎn)醫(yī)院投入-產(chǎn)出效率總體有效的醫(yī)院分別為4家、4家、3家,純技術(shù)效率的平均值為分別為95.3%、89.9%、92.7%。 3)晚血患者次均住院費(fèi)用為4662.69元,影響住院費(fèi)用可控因素有藥費(fèi)、住院天數(shù)、治療費(fèi)、檢查費(fèi);非可控因素有并發(fā)癥、手術(shù)治療、脾切史、疫情類別。 4)接受救治后晚血患者生命質(zhì)量平均得分為0.743,其對(duì)自身的活動(dòng)能力、自我照顧能力、日�；顒�(dòng)能力及焦慮沮喪的評(píng)價(jià)較好,滿意率分別為69.1%、60.0%、60.0%、63.6%,而對(duì)疼痛和不適的評(píng)價(jià)較差,滿意率僅為36.4%,晚血患者對(duì)晚血救治醫(yī)療機(jī)構(gòu)8個(gè)方面的滿意率7項(xiàng)指標(biāo)達(dá)到70.0%以上。 結(jié)論與建議 根據(jù)上述調(diào)查結(jié)果,本研究提出以下幾點(diǎn)結(jié)論和建議:1)荊州市晚血救治醫(yī)療資源利用效率較高,應(yīng)針對(duì)數(shù)據(jù)包絡(luò)分析量化結(jié)果加強(qiáng)改善;2)晚血救治政策補(bǔ)助標(biāo)準(zhǔn)適宜,應(yīng)多渠道多手段優(yōu)化有限衛(wèi)生資源配置,提高資源利用效率;3)加強(qiáng)合理用藥管理,適度控制藥品費(fèi)用;4)合理選擇檢查治療方案,最大程度發(fā)揮各項(xiàng)檢查治療手段的作用;5)縮短住院天數(shù),提高醫(yī)療質(zhì)量;6)加大晚血普查工作力度,引導(dǎo)患者合理及時(shí)就醫(yī);7)晚血患者生命質(zhì)量和滿意度較高,仍有提升空間,應(yīng)積極改善就醫(yī)環(huán)境,完善其出院后的后續(xù)管理工作。
[Abstract]:research objective
This study from two aspects of medical service supplier and demander, the output efficiency of hospital treatment work late blood input treatment to the Jingzhou City, Hubei province 8 late night blood, the blood of patients with hospitalization expenditure and its affecting factors, comprehensive evaluation of the quality of life of patients with advanced schistosomiasis, evaluating the effect and benefit of late blood treatment that night, the blood treatment problem in the work, and related policies in order to improve the treatment of late blood, optimize the allocation of limited health resources and provide a scientific basis for improving the treatment of late blood benefits.
research contents
The main contents of this study are late treatment blood performance evaluation from medical service supplier perspective include: 1) Jingzhou city night blood treatment basic understanding of Jingzhou city hospitals, 8 hospitals and blood late treatment scale, nature, TREATMFNT of job involvement, money, and 2006-2008 3 years later the blood treatment work; 2) Jingzhou City night blood treatment hospitals input-output efficiency evaluation, understand Jingzhou city night blood treatment hospitals in the late blood treatment efficiency of resource allocation, and the variation trend analysis of time series of 3 years for the hospital to know the allocation efficiency; 3) late blood treatment in designated hospitals the blood of the patients with late fees, a comprehensive analysis of the composition of blood late hospitalization expenses of patients, identify the factors influencing control and can not control the hospitalization expenses. From the perspective of the main contents of medical service performance evaluation of the late blood treatment are: 1) After receiving the treatment, the quality of life of the late blood patients was reviewed. 2) the satisfaction degree of the late blood patients to the medical institutions for late blood treatment was evaluated; 3) the changes of the production, life and quality of life after the treatment of the late blood patients and their feelings and evaluation on the implementation of the late blood treatment policy.
research method
This research mainly uses the literature research, field investigation and other methods to collect relevant information and data, the application of Epidata3.02, SPSS17.0 and Deap2.1 software, using descriptive analysis, data envelopment analysis and multi factor analysis and grey correlation method for blood treatment of late designated hospitals 2006-2008 a total of 3 years of Jingzhou city 8 home late blood. The input-output efficiency of hospitalized patients with late blood composition and influencing factors of the cost of the comprehensive analysis, combined with the quality of life of EQ-5D and evaluate the quality of life of qualitative interviews after receiving treatment in patients with late.
Research results
1) there are seven hospitals set up specifically for treatment of advanced schistosomiasis beds, the average night blood treatment special grant special beds accounted for the total bed number ratio of 72.7%. in Jingzhou city in 2008 late patients hospitalized more than 15% growth in 2006, the number of cases in late 2008 for treatment of blood than in 2006 an increase of 3.68%.
2) in 2006-2008 years, 8 inpatients with late blood treatment designated hospitals in Jingzhou had input output efficiency of 4, 4, 3, and the average of pure technical efficiency was 95.3%, 89.9%, 92.7%. respectively.
3) the average hospitalization cost of late blood patients is 4662.69 yuan. The factors influencing hospitalization expenses include drug fees, hospitalization days, treatment fees and examination fees. There are complications of non controllable factors, surgical treatment, splenic cutting history and epidemic types.
4) receiving treatment after the quality of life of patients with late the average score was 0.743, for its own ability, self-care ability, ability of daily activities and anxiety and depression evaluation is good, the satisfaction rate were 69.1%, 60%, 60%, 63.6%, and the discomfort of pain and evaluation of the poor, the satisfaction rate was only 36.4%, to the satisfaction of the 8 aspects of medical treatment of patients with late night blood rate of 7 index reached more than 70%.
Conclusions and suggestions
According to the above findings, this study gives the following conclusions and recommendations: 1) higher efficiency of utilization of medical resources in the city of Jingzhou night blood treatment, according to data envelopment analysis to quantify the results of improvement; 2) late blood treatment policy subsidy standards should be appropriate, optimizing the allocation of limited health resources with multi channels and means to improve the efficiency of resource utilization; 3) to strengthen the management of rational drug use, moderate drug cost control; 4) reasonable examination treatment, maximize the inspection treatment effect; 5) shortening hospitalization time, improve the quality of medical care; 6) increase TREATMFNT census efforts to guide the patient and reasonable timely medical treatment; 7) late life quality and satisfaction of patients with blood high, there is still room for improvement, we should actively improve the medical environment, improve the follow-up management of the hospital.

【學(xué)位授予單位】：華中科技大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2011
【分類號(hào)】：R532.21;R184

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