本文選題：服務(wù)能力 + 西藏縣級醫(yī)院　； 參考：《北京中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：背景:西藏和平解放60多年,醫(yī)療服務(wù)體系取得了翻天覆地的變化,縣級醫(yī)院醫(yī)療服務(wù)能力得到很大的提升,但和內(nèi)地縣級醫(yī)院相比,仍存在很大的差距。中央第六次西藏工作座談會對西藏醫(yī)療服務(wù)能力提出了更高要求,其中縣級醫(yī)院醫(yī)療服務(wù)能力的提升是必不可少的一部分。目前西藏自治區(qū)縣級醫(yī)院基本沒有分科,加上缺乏檢驗、麻醉等醫(yī)技人員,只有少數(shù)縣人民醫(yī)院能開展下腹部手術(shù),遠不能滿足居民的衛(wèi)生服務(wù)需求,因此需要根據(jù)縣級醫(yī)院服務(wù)能力現(xiàn)狀,構(gòu)建一套適用于西藏自治區(qū)縣級醫(yī)院的評價指標(biāo)體系,對縣級醫(yī)院的服務(wù)能力進行激勵和約束,促進服務(wù)能力的提升。目的:本研究旨在通過定量與定性研究方法的綜合運用,構(gòu)建適合西藏縣級綜合醫(yī)院服務(wù)能力評價指標(biāo)體系,并運用指標(biāo)體系對醫(yī)院進行服務(wù)能力評價,促進服務(wù)能力提升。方法:采用文獻分析法、焦點組訪談和專家咨詢法確定評價指標(biāo)體系,運用模糊數(shù)學(xué)綜合評判法確定指標(biāo)權(quán)重。內(nèi)容:以系統(tǒng)管理理論和UNDP能力評價模型為導(dǎo)向,基于文獻研究、焦點組訪談與專家咨詢法,確定評價指標(biāo),采用Fuzzy綜合評判法計算各指標(biāo)權(quán)重,最終確定指標(biāo)體系。結(jié)果:(1)德爾菲專家咨詢法選擇了熟悉西藏縣級醫(yī)院服務(wù)能力情況的27位專家,第一輪專家積極系數(shù)100%,第二輪專家積極系數(shù)88.89%,一級指標(biāo)的權(quán)威程度均≥0.82。(2)通過專家咨詢等方法確定的指標(biāo)體系包括基礎(chǔ)設(shè)施、人力資源、診療科目、醫(yī)療服務(wù)、醫(yī)療管理和經(jīng)濟管理共6個一級指標(biāo)、12個二級指標(biāo)和58個三級指標(biāo)。(3)根據(jù)專家對于指標(biāo)重要性、可操作性和敏感性三者的打分情況,計算出權(quán)重中的隸屬度,應(yīng)用模糊數(shù)學(xué)綜合評價計算指標(biāo)權(quán)重,一級指標(biāo)權(quán)重為基礎(chǔ)設(shè)施0.171179、人力資源0.162567、診療科目0.165230、醫(yī)療服務(wù)0.173903、醫(yī)療管理0.170197、經(jīng)濟管 0.156926。結(jié)論:(1)從基礎(chǔ)設(shè)施、人力資源、診療科目、醫(yī)療服務(wù)、醫(yī)療管理和經(jīng)濟管理6個方面構(gòu)建的指標(biāo)體系合理、可行。(2)本研究遴選的專家具有代表性,選擇方法適宜西藏實際情況,指標(biāo)篩選合理。(3)在專家評分的基礎(chǔ)上,運用模糊數(shù)學(xué)綜合評價法計算指標(biāo)權(quán)重,方法可行,結(jié)果可信。
[Abstract]:Background: more than 60 years after the peaceful liberation of Tibet, the medical service system has made tremendous changes, and the medical service capacity of county-level hospitals has been greatly improved, but there is still a big gap compared with the county-level hospitals in the mainland. The sixth Tibet work Symposium of the Central Committee has put forward higher requirements for the medical service capacity of Tibet, and the upgrading of the medical service capacity of county-level hospitals is an essential part. At present, there are basically no departments in the county hospitals of the Tibet Autonomous region. In addition to the lack of medical technicians such as testing and anesthesia, only a few county people's hospitals can perform lower abdominal surgery, which is far from meeting the health service needs of the residents. Therefore, it is necessary to construct a set of evaluation index system suitable for county hospitals in Tibet Autonomous region according to the present situation of service capacity of county-level hospitals, to motivate and restrain the service capacity of county-level hospitals, and to promote the promotion of service capacity. Objective: the purpose of this study is to establish an evaluation index system for the service capacity of Tibet county-level general hospitals through the comprehensive application of quantitative and qualitative research methods, and to use the index system to evaluate the service capacity of hospitals to promote the promotion of service capacity. Methods: literature analysis, focus group interview and expert consultation were used to determine the evaluation index system, and fuzzy mathematics comprehensive evaluation method was used to determine the index weight. Content: based on the theory of system management and the evaluation model of UNDP ability, based on literature research, focus group interview and expert consultation, the evaluation index is determined, and the weight of each index is calculated by Fuzzy comprehensive evaluation method, and the index system is finally determined. Results the Delphi expert consultation method selected 27 experts who were familiar with the service capacity of hospitals at the county level in Tibet. The first round of expert positive coefficient 100, the second round expert positive coefficient 88.89, the primary index authority degree 鈮，

本文編號：1908810