摘要
目的:构建某三级甲等综合医院临床科室医疗服务质量评价体系。方法:在医疗服务质量"结构-过程-结果"三维度理论基础上,结合当前医院管理实际,运用文献分析法和德尔菲法建立医疗服务质量评价体系,并用该体系对随机抽取的某三级甲等综合医院11个临床科室医疗服务质量进行评价。将层次分析法和熵值法相结合,采用最优组合赋权法计算各指标的权重。采用加权极差化法、加权秩和比法、加权TOPSIS法3种综合评价法构建综合评价模型,用危重病例率校正3种方法的评价结果后,用标准化法进行组合评价。结果:经过两轮专家咨询确立了包含3个维度的一级指标、13个二级指标和25个三级指标的评价指标体系,总体信度系数(克朗巴赫a系数)为0.840,结构质量维度为0.811,过程质量维度为0.704,结果质量维度为0.875。3种方法的评价结果高度一致(校正前协调系数w=0.826,P=0.006;校正后w=0.929,P=0.002)。组合评价结果显示11个临床科室中医疗服务质量最好的是普外一科,与实际相符。结论:建立的评价体系和评价方法具有较好的科学性与可行性。
Aim：To construct a comprehensive evaluation system for the medical service quality of clinical departments from a 3A-general hospital. Methods：Based on the medical service quality three content ＂structure-process-results＂,and combined with the current situation of hospital management,literature analysis method and Delphi method were used to construct a comprehensive evaluation system. A total of 11 clinical departments from one 3A-general hospital were randomly selected for on-site research. The combination of AHP and entropy weighting method was used to calculate each index weight coefficient. The weighted range method,the weighted rank sum ratio method,and the weighted TOPSIS were used to build comprehensive evaluation models,and to evaluate the quality of medical service of the 11 clinical departments. Correction factor（ rate of critical illness） was used to correct the evaluation results of three evaluation methods. The standardized method was used for combination evaluation. Results：The constructed comprehensive evaluation system included 3 first level indicators,13 second level indicators, and 25 third level indicators,the reliability coefficient（ Cronbach＇s a coefficient） of the total evaluation system was 0. 840,and the structural quality dimension,the process quality dimension and the result quality dimension were 0. 811,0. 704 and 0. 875. Three evaluation methods had a high degree of consistent[the coordination coefficient w was 0. 826（ P = 0. 006） before adjusted,and it was 0. 909（ P = 0. 002） after adjusted]. The combined evaluation result showed that the medical service quality of the general surgery department was the best. Conclusion：The evaluation system is scientific and feasible.
出处
《郑州大学学报（医学版）》
CAS
北大核心
2013年第6期795-799,共5页
Journal of Zhengzhou University(Medical Sciences)
基金
兵团科技计划基金资助项目2013BA027
关键词
医疗服务质量
评价体系
综合评价
medical service quality
evaluation system
comprehensive evaluation
