本文選題：數(shù)字化醫(yī)院 + 軍隊(duì)醫(yī)院�。� 參考：《第三軍醫(yī)大學(xué)》2011年博士論文

【摘要】：研究背景: 突發(fā)公共衛(wèi)生事件是指突然發(fā)生的,對(duì)公眾健康造成或者可能造成重大損失的傳染病疫情、不明原因的群體性疾病、重大食物和職業(yè)中毒,以及其他危害公共健康的事件。近年來,我國(guó)面臨突發(fā)公共衛(wèi)生事件的威脅有不斷上升的趨勢(shì),醫(yī)院是應(yīng)對(duì)突發(fā)公共衛(wèi)生事件中的關(guān)鍵機(jī)構(gòu),醫(yī)院突發(fā)公共衛(wèi)生事件應(yīng)對(duì)能力的提升在我國(guó)突發(fā)公共衛(wèi)生事件應(yīng)對(duì)體系建設(shè)中的作用十分重要。醫(yī)院突發(fā)公共衛(wèi)生事件應(yīng)對(duì)能力評(píng)價(jià)是醫(yī)院應(yīng)對(duì)能力建設(shè)的基礎(chǔ),數(shù)字化醫(yī)院是醫(yī)院發(fā)展的必然趨勢(shì),但目前尚沒有數(shù)字化醫(yī)院突發(fā)公共衛(wèi)生事件應(yīng)對(duì)能力評(píng)價(jià)相關(guān)的研究報(bào)道。為了保證獲取研究數(shù)據(jù)的可行性,結(jié)合本單位在軍隊(duì)數(shù)字化醫(yī)院建設(shè)方面的多年經(jīng)驗(yàn),我們選擇軍隊(duì)數(shù)字化醫(yī)院做為本研究的研究對(duì)象。 目的: 一、構(gòu)建數(shù)字化醫(yī)院突發(fā)公共衛(wèi)生事件應(yīng)對(duì)能力評(píng)價(jià)指標(biāo)體系; 二、編制數(shù)字化醫(yī)院突發(fā)公共衛(wèi)生事件應(yīng)對(duì)能力調(diào)查問卷; 三、建立數(shù)字化醫(yī)院突發(fā)公共衛(wèi)生事件應(yīng)對(duì)能力綜合評(píng)價(jià)模型; 四、利用數(shù)字化醫(yī)院突發(fā)公共衛(wèi)生事件應(yīng)對(duì)能力調(diào)查問卷和綜合評(píng)價(jià)模型,調(diào)查、分析和評(píng)價(jià)軍隊(duì)數(shù)字化醫(yī)院的應(yīng)對(duì)能力 五、基于以上研究,找出軍隊(duì)數(shù)字化醫(yī)院突發(fā)公共衛(wèi)生事件應(yīng)對(duì)能力現(xiàn)狀的不足,為后續(xù)軍隊(duì)數(shù)字化醫(yī)院應(yīng)對(duì)能力的建設(shè)和提高提供初步的理論依據(jù)。 方法: 通過文獻(xiàn)調(diào)研和專家訪談,構(gòu)建數(shù)字化醫(yī)院突發(fā)公共衛(wèi)生事件應(yīng)對(duì)能力初步評(píng)價(jià)指標(biāo)體系,并通過后續(xù)兩輪專家咨詢法和層次分析法,確定最終評(píng)價(jià)指標(biāo)體系組成和權(quán)重。依據(jù)前期構(gòu)建的評(píng)價(jià)指標(biāo)體系,編制數(shù)字化醫(yī)院突發(fā)公共衛(wèi)生事件應(yīng)對(duì)能力調(diào)查問卷,對(duì)抽取的軍隊(duì)數(shù)字化醫(yī)院應(yīng)對(duì)能力現(xiàn)狀進(jìn)行調(diào)查分析。通過建立數(shù)字化醫(yī)院突發(fā)公共衛(wèi)生事件應(yīng)對(duì)能力綜合評(píng)價(jià)加權(quán)線性模型,量化數(shù)字化醫(yī)院突發(fā)公共衛(wèi)生事件應(yīng)對(duì)能力,結(jié)合軍隊(duì)數(shù)字化醫(yī)院應(yīng)對(duì)能力現(xiàn)狀調(diào)查的結(jié)果,對(duì)軍隊(duì)數(shù)字化醫(yī)院突發(fā)公共衛(wèi)生事件應(yīng)對(duì)能力現(xiàn)狀進(jìn)行分析和評(píng)價(jià)。 結(jié)果: 1、成功構(gòu)建了數(shù)字化醫(yī)院突發(fā)公共衛(wèi)生事件應(yīng)對(duì)能力評(píng)價(jià)指標(biāo)體系,該指標(biāo)體系包括6個(gè)一級(jí)指標(biāo)、20個(gè)二級(jí)指標(biāo)和56個(gè)三級(jí)指標(biāo); 2、構(gòu)建的數(shù)字化醫(yī)院突發(fā)公共衛(wèi)生事件應(yīng)對(duì)能力評(píng)價(jià)指標(biāo)體系經(jīng)檢測(cè)具有較好的信度和效度,可以用于后續(xù)軍隊(duì)數(shù)字化醫(yī)院突發(fā)公共衛(wèi)生事件應(yīng)對(duì)能力現(xiàn)狀調(diào)查研究; 3、構(gòu)建了數(shù)字化醫(yī)院突發(fā)公共衛(wèi)生事件應(yīng)對(duì)能力綜合評(píng)價(jià)模型公式: Z=1000*0.16*[0.35*(0.40*C1+0.28*C2+0.32*C3)+...+0.30*(0.26*C7+0.32*C8+0.32*C9)]+...1000*0.15*[0.34*(0.29*C46+0.23*C47+0.21*C48+0.27*C49)+...+0.30*(0.30*C53+0.20*C54+0.22*C55+0.28*C56)]。 其中Z為數(shù)字化醫(yī)院應(yīng)對(duì)能力綜合得分,C1、C2、C56等表示所對(duì)應(yīng)三級(jí)指標(biāo)的實(shí)際調(diào)查得分。 4、軍隊(duì)數(shù)字化醫(yī)院具備較完善的突發(fā)公共衛(wèi)生事件應(yīng)對(duì)能力現(xiàn)狀調(diào)查發(fā)現(xiàn):被調(diào)查的軍隊(duì)數(shù)字化醫(yī)院在應(yīng)急制度、監(jiān)測(cè)預(yù)警、院內(nèi)外醫(yī)療處置、應(yīng)急儲(chǔ)備、人員和設(shè)備安全、教育與改進(jìn)6個(gè)方面均有不足。特別是在利用數(shù)字化手段優(yōu)化數(shù)字化醫(yī)院以上6個(gè)方面能力上,大部分被調(diào)查醫(yī)院還有很大潛力可挖。 5、軍隊(duì)數(shù)字化醫(yī)院突發(fā)公共衛(wèi)生事件應(yīng)對(duì)能力評(píng)價(jià)研究發(fā)現(xiàn):中心醫(yī)院以上級(jí)別醫(yī)院強(qiáng)于中心醫(yī)院,教學(xué)醫(yī)院強(qiáng)于非教學(xué)醫(yī)院,SARS重災(zāi)區(qū)醫(yī)院強(qiáng)于非SARS重災(zāi)區(qū)醫(yī)院、收治過SARS患者/疑似患者醫(yī)院強(qiáng)于未收治過相應(yīng)患者醫(yī)院,東部醫(yī)院強(qiáng)于西部醫(yī)院,南部和北部醫(yī)院應(yīng)對(duì)能力無明顯差別。 結(jié)論: 1、本研究成功構(gòu)建了合理可行的數(shù)字化醫(yī)院突發(fā)公共衛(wèi)生事件應(yīng)對(duì)能力評(píng)價(jià)指標(biāo)體系。 2、本研究調(diào)查的軍隊(duì)數(shù)字化醫(yī)院在應(yīng)急制度、監(jiān)測(cè)預(yù)警、院內(nèi)外醫(yī)療處置、應(yīng)急儲(chǔ)備、人員和設(shè)備安全、教育與改進(jìn)6個(gè)方面都有不小的提升空間;特別是在結(jié)合數(shù)字化手段提升醫(yī)院以上6個(gè)方面能力上,還有較大潛力。 3、中心醫(yī)院以上級(jí)別醫(yī)院突發(fā)公共衛(wèi)生事件應(yīng)對(duì)能力強(qiáng)于中心醫(yī)院,教學(xué)醫(yī)院強(qiáng)于非教學(xué)醫(yī)院,SARS重災(zāi)區(qū)醫(yī)院強(qiáng)于非SARS重災(zāi)區(qū)醫(yī)院、收治過SARS患者/疑似患者醫(yī)院強(qiáng)于未收治過相應(yīng)患者醫(yī)院,東部醫(yī)院強(qiáng)于西部醫(yī)院,南部和北部醫(yī)院應(yīng)對(duì)能力無明顯差別。 本研究創(chuàng)新性: 1、首次構(gòu)建了數(shù)字化醫(yī)院突發(fā)公共衛(wèi)生事件應(yīng)對(duì)能力評(píng)價(jià)指標(biāo)體系。 2、首次編制了數(shù)字化醫(yī)院突發(fā)公共衛(wèi)生事件應(yīng)對(duì)能力評(píng)價(jià)問卷,對(duì)抽取的軍隊(duì)數(shù)字化醫(yī)院突發(fā)公共衛(wèi)生事件應(yīng)對(duì)能力現(xiàn)狀進(jìn)行了調(diào)查和分析。 3、首次建立了數(shù)字化醫(yī)院突發(fā)公共衛(wèi)生事件應(yīng)對(duì)能力綜合評(píng)價(jià)模型,結(jié)合對(duì)軍隊(duì)數(shù)字化醫(yī)院相關(guān)調(diào)查結(jié)果,對(duì)軍隊(duì)數(shù)字化醫(yī)院應(yīng)對(duì)能力進(jìn)行了分析和評(píng)價(jià)。 以上研究首次對(duì)軍隊(duì)數(shù)字化醫(yī)院應(yīng)對(duì)突發(fā)公共衛(wèi)生事件應(yīng)對(duì)能力現(xiàn)狀進(jìn)行了調(diào)查、分析和評(píng)價(jià),找出了軍隊(duì)數(shù)字化醫(yī)院突發(fā)公共衛(wèi)生事件應(yīng)對(duì)能力現(xiàn)狀的不足,并提出了相應(yīng)的改進(jìn)意見,為后續(xù)軍隊(duì)數(shù)字化醫(yī)院應(yīng)對(duì)能力的建設(shè)和提高提供初步的理論依據(jù)。
[Abstract]:Research background:
Public health emergencies are sudden, infectious diseases that cause or may cause significant losses to public health, unexplained mass diseases, major food and occupational poisoning, and other incidents endangering public health. In recent years, the threat of public health emergencies in China has been increasing, medical treatment has been increasing. The hospital is the key organization to deal with the emergency public health events. The improvement of the emergency response ability of the public health incidents in the hospital is very important in the construction of the public health emergency response system in China. The evaluation of the coping ability of the emergency public health events in the hospital is the basis of the construction of the hospital's coping ability, and the digital hospital is the development of the hospital. In order to ensure the feasibility of obtaining the research data, we have chosen the military digital hospital as the research object of this research in order to ensure the feasibility of obtaining the research data, and combine the years experience of the unit in the construction of the military digital hospital.
Objective:
First, we should set up an evaluation index system for responding to public health emergencies in digital hospitals.
Two, compiling a questionnaire on coping ability of public health emergencies in digital hospitals.
Three, establish a comprehensive evaluation model of public health emergency response capability in digital hospitals.
Four, to investigate, analyze and evaluate the coping ability of the military digital hospital by using the questionnaire and the comprehensive evaluation model of the coping capacity of emergency public health events in digital hospital.
Five, based on the above research, we find out the shortage of the current situation of coping capacity of public health emergency in military digital hospital, and provide a preliminary theoretical basis for the construction and improvement of the ability of the follow-up military digital hospital.
Method:
Through literature investigation and expert interview, the preliminary evaluation index system of coping capacity of public health emergency in digital hospital is constructed, and the composition and weight of the final evaluation index system are determined through two rounds of expert consultation and analytic hierarchy process. According to the evaluation index system built earlier, the public health emergency in digital hospital is compiled. In order to quantify the coping ability of emergency public health events in digital hospitals by establishing a weighted linear model of comprehensive evaluation of public health emergency response ability in digital hospitals, the present situation of coping ability of digital hospitals was quantified. Based on the results of the investigation, the present situation of coping ability of public health emergencies in military digital hospitals is analyzed and evaluated.
Result:
1, the evaluation index system of coping capacity of public health emergencies in digital hospital was constructed successfully. The index system includes 6 first grade indexes, 20 two level indexes and 56 three level indexes.
2, the evaluation index system of emergent public health emergency response ability of digital hospital has good reliability and validity, and it can be used in the investigation and Research on the response ability of emergency public health events in the follow-up military digital hospital.
3, a comprehensive evaluation model formula for the response ability of public health emergencies in digital hospital: Z=1000*0.16*[0.35* (0.40*C1+0.28*C2+0.32*C3) +... +0.30* (0.26*C7+0.32*C8+0.32*C9)] +... 1000*0.15*[0.34* (0.29*C46+0.23*C47+0.21*C48+0.27*C49) +... +0.30* (0.30*C53+0.20*C54+0.22*C55+0.28*C56)).
Among them, Z is the comprehensive score of the coping ability of digital hospitals, C1, C2, C56 and so on, which represent the actual survey scores corresponding to the three level indicators.
4, it is found that the military digital hospital has a better ability to respond to public health emergencies. It is found that the investigated military digital hospital has 6 shortcomings in the emergency system, monitoring and warning, medical disposal at home and abroad, emergency reserve, personnel and equipment safety, and education and improvement, especially in the use of digital means to optimize the numbers. In the above 6 aspects of hospital capacity, most of the surveyed hospitals still have great potential to tap.
5, the evaluation of coping ability of emergency public health events in the military digital hospital found that the hospital above the central hospital is stronger than the Central Hospital, the teaching hospital is stronger than the non teaching hospital, the SARS area hospital is stronger than the non SARS heavy disaster area hospital, and the SARS patients / suspected patients medical hospital is stronger than that of the corresponding hospital, and the Eastern Hospital is strong. There was no significant difference in coping capacity between Western and southern hospitals.
Conclusion:
1, this study successfully constructed a reasonable and feasible evaluation index system for the response ability of public health emergencies in digital hospitals.
2, the investigation of the military digital hospital in the emergency system, monitoring and early warning, medical disposal at home and abroad, emergency reserve, personnel and equipment safety, education and improvement of the 6 aspects of the promotion of space, especially in the combination of digital means to improve the capacity of the hospital above 6 aspects, there is a great potential.
3, the emergency response ability of the public health emergency in the hospital above the central hospital is stronger than the Central Hospital, the teaching hospital is stronger than the non teaching hospital, the SARS area hospital is stronger than the non SARS heavy disaster area hospital, the SARS patients / suspected patient hospital is stronger than the corresponding hospital, the Eastern Hospital is stronger than the Western Hospital, the South and the northern hospital should be There is no obvious difference in ability.
This research is innovative:
1, for the first time, the evaluation index system of public health emergency response capability in digital hospitals was constructed for the first time.
2, for the first time, a questionnaire on the response ability of the digital hospital emergency public health events was compiled, and the status of the emergency response ability of the emergency public health events in the military digital hospital was investigated and analyzed.
3, for the first time, a comprehensive evaluation model of coping capacity of public health emergency in digital hospital was established, and combined with the investigation results of military digital hospital, the response ability of military digital hospital was analyzed and evaluated.
The above research is the first time to investigate the status of coping ability of the military digital hospital in response to the emergency public health events. Analysis and evaluation, and find out the shortage of the current situation of the emergency response ability of the military digital hospital, and put forward some suggestions for improvement to build and improve the ability of the follow-up military digital hospital. Provide a preliminary theoretical basis.
【學(xué)位授予單位】：第三軍醫(yī)大學(xué)
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2011
【分類號(hào)】：R82

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2 趙琦;基層突發(fā)公共衛(wèi)生事件應(yīng)急體系應(yīng)對(duì)能力評(píng)估工具的開發(fā)、應(yīng)用與評(píng)估模型的探索性研究[D];復(fù)旦大學(xué);2009年

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