摘要
目的分析医疗保险支付改革背景下综合医院临床科室的护理效率表现,探讨合理配置资源、提高服务效率的方法。方法选取2020年1—12月青岛市市立医院相关数据,采用数据包络分析和Malmquist指数对该医院20个临床科室的护理效率进行评价,投入指标为护士数、工时数、开放床位数,产出指标为出院例数、平均住院日、病例组合指数。结果该院2020年20个临床科室的综合效率、纯技术效率、规模效率平均值分别为0.845、0.913、0.923,2020年2—4月、5—9月、10—11月的全要素生产效率指数均>1,但1—12月全要素生产效率指数<l,全要素生产效率指数>1的科室有5个。结论临床科室的护理综合效率有待提升,疾病诊断相关分组对内科护理效率管理提出更严峻的挑战,新型冠状病毒肺炎疫情对护理服务效率影响较大,数据包络分析模型和疾病诊断相关分组相关指标进行护理效率评价具有一定的可行性,应结合科室收治患者疾病特征和护理工作特点,挖掘深层原因,综合施策改善护理效率状况,探索基于医疗保险支付方式改革的精准护理服务转型,推进互联网+护理服务,关注常态化疫情防控现状下护理资源效能的提升。
Objective To analyze the nursing efficiency of clinical departments in general hospitals under the background of medical insurance payment reform,and to explore the methods of rational allocation of resources and improvement of service efficiency.Methods The relevant data of Qingdao Municipal Hospital from January to December 2020 were selected.The nursing efficiency of 20 clinical departments in the hospital was evaluated by data envelopment analysis(DEA)and Malmquist index.The input indexes were the number of nurses,the number of hours,the number of open beds.The output indicators were number of discharges,average length of stay,and case mix index.Results In 2020,the average comprehensive efficiency,pure technical efficiency and scale efficiency of 20 clinical departments in the hospital were 0.845,0.913 and 0.923,respectively.The total factor production efficiency index of the hospital from February to April,from May to September and from October to November were all greater than 1,but the total factor production efficiency index from January to December was less than 1.There were 5 departments with total factor production efficiency index greater than 1.Conclusions The comprehensive nursing efficiency of clinical departments needs to be improved,and diagnosis related groups(DRG)poses a more severe challenge to the efficiency management of internal medicine nursing.The COVID-19 epidemic has a great impact on the efficiency of nursing services.It is feasible to evaluate the nursing efficiency with DEA model and DRG related indicators.Combined with the disease characteristics and nursing work characteristics of patients admitted to the department,the deep causes should be explored,comprehensive measures should be taken to improve nursing efficiency,precise nursing service transformation based on the reform of medical insurance payment mode should be explored,Internet+nursing service should be promoted,and the improvement of nursing resource efficiency under the status of normal epidemic prevention and control sh
作者
郇姗姗
孙秀杰
王秀彬
Huan Shanshan;Sun Xiujie;Wang Xiubin(Nursing Department,Qingdao Municiple Hospital,Qingdao 266071,China;Quality Management and Assessment Departent,Qingdao Municiple Hospital,Qingdao 266071,China)
出处
《中国实用护理杂志》
2022年第36期2838-2844,共7页
Chinese Journal of Practical Nursing
