摘要
目的:探索基于病案首页数据建立手术并发症监控模式,并分析其对手术并发症发生率变化趋势的影响。方法:广州市某三级综合医院以绩效考核中手术并发症发生率数据为核心要素,基于"结构-过程-结果"框架构建手术并发症监控模式。通过全国三级公立医院绩效考核病案首页采集系统,收集该医院2019年1月至2022年6月的手术并发症发生例数和同期出院手术患者人数。对手术并发症发生率采用描述性分析,采用Joinpoint回归分析手术并发症发生率的变化趋势,并计算月变化百分比(MPC)和平均月变化百分比(AMPC)。结果:医院自2021年5月开始实施手术并发症监控模式,手术并发症发生率从2021年6月的2.55%下降至2022年6月的0.82%,MPC为-5.58%(P=0.024),优于2019年1月至2021年5月的变化情况(MPC=0.18%,P=0.755)。结论:医院构建的手术并发症监控模式可以有效降低手术并发症发生率,为优化医院医疗质量管理流程和决策模式提供参考。
Objective To explore the establishment of a surgical complication monitoring mode based on data on the medical record homepage,and analyze its impact on the trend of changes in surgical complication incidence.Methods A monitoring mode of surgical complication was developed based on the"structure-process-results"framework by using surgical complication rates derived from performance appraisal for a tertiary general hospital in Guangzhou.The number of surgical complications and the number of discharged surgical patients was collected from the hospital from January 2019 to June 2022 through the home page collection system for performance appraisal of national tertiary public hospitals.Descriptive analysis was used to analyze the incidence of surgical complications,and Joinpoint regression was used to analyze the trend of changes in the incidence of surgical complications.Monthly percentage change(MPC)and average monthly percentage change(AMPC)were calculated.Results Since the hospital began implementing the surgical complication monitoring mode in May 2021,the incidence of surgical complications had decreased from 2.55%in June 2021 to 0.82%in June 2022,with an MPC of-5.58%(P=0.024),which was better than the changes from January 2019 to May 2021(MPC=0.18%,P=0.755).Conclusions The surgical complication monitoring mode constructed by the hospital can effectively reduce the incidence of surgical complications,providing reference for optimizing hospital′s medical quality management process and decision-making mode.
作者
张冠荣
梁会营
李丹
薛允莲
叶晋奇
杨小红
Zhang Guanrong;Liang Huiying;Li Dan;Xue Yunlian;Ye Jinqi;Yang Xiaohong(Department of Information Management,Guangdong Provincial People′s Hospital(Guangdong Academy of Medical Sciences)Southern Medical University,Guangzhou 510080,China)
出处
《中华医院管理杂志》
CSCD
北大核心
2023年第2期113-118,共6页
Chinese Journal of Hospital Administration
基金
国家卫生健康委卫生健康统计工作高质量发展揭榜攻关项目(2022)
广东省卫生经济学会重点课题(2022-WJZD-14)。
关键词
诊疗工作管理
医学
手术并发症
防控措施
病案首页
发生率
监测体系
Practice management,medical
Surgical complication
Preventive and control measures
Medical record home page
Incidence rate
Monitoring framework
