摘要
目的:根据危重病学领域临床路径技术定位的需求功能与病人生理监测仪集成化配置功能之间的对应映射关系,研究医学装备技术的双向功能配置评估模式。方法:运用文献评阅构建临床路径需求功能与PPM配置功能双向评估指标体系;通过Delphi法确定功能对在5个CCM领域(急诊科、综合ICU、CCU、麻醉/术中监测和术后恢复病房5个科室)的权重,建立功能对关系矩阵,分析功能对在CCM领域里的重要度;用调研获得的实际功能利用效率校正主观权重,然后采用组合赋权法再确定功能对指标权重,最后运用系统聚类分析和绝对重要度排序集成,生成PPM功能配置评估方案。结果:聚类分析与绝对重要度集成分析结果显示,ECG、NIBP和SpO2监测是CCM各临床路径的基本配置功能,IBP、心输出量等其他监测功能,依据临床路径的功能定位不同有所差异。结论:对功能分解集成程度较高的PPM,在CCM临床路径的需求功能和PPM配置功能双向指标体系基础上,先构建评估功能对,再综合运用Delphi问卷、双向功能矩阵分析、组合赋权、聚类分析等方法,测量生理监测仪的功能配置,可完成功能配置评估;而调研实际功能技术利用效率,用做校正主观权重,使评估结果更接近实际。
Objective To investigate healthcare device technology deploying assessment model according to the mapping relationship between the technical functions requirements of the clinical pathway and integrating functions of the patient physiological monitor（PPM）,and set up configurations of PPM function deployment suitable for critical care medicine（CCM） fields.Methods The bidirectional assessment parameter systems for requiring functions and equipping with functions were constructed by the literature review.Matched function pairs of CCM process requirements and PPM equipment functions were formed based on the bidirectional assessment parameter systems.The weighting for functions pairs was calculated by Delphi method.The subjective weighting was calibrated based on actual function utilized rate,and then the weighting for the function pairs was reconfirmed by the combination weighting method.The proposals for the function deployment of the physiological monitor which met technical demands in CCM fields were produced by the cluster analysis and the absolute importance ranked.Results The integrated analysis of the cluster and the absolute importance ranked showed that ECG,NIBP and SpO2 are the essential function pairs among the CCM fields.The other monitor function,IBP and cardiac output for instance,was different depend on technical allocation of clinical pathway.For example,the absolute importance and ranking of the multi-channel ECG monitoring in CCU were higher than ER and OR,and IBP in ICU was higher than others.Conclusion Based on the requiring function for clinical pathway,the integrated Delphi and cluster to measure the function parameters for the PPM can be performed in the technology deploying assessment.The assessment procedures can be simplified by fitted function pairs for the PPM integrated function parameters.It is an important way that investigated the actual function utilized rate for the PPM to calibrate the subjective weighting,so that the assessed results are closed to the practical application and function allocations for clinical procedures.
出处
《医疗卫生装备》
CAS
2011年第5期9-12,30,共5页
Chinese Medical Equipment Journal
基金
卫生部中国卫生经济学会第十一批招标课题(CHEA1011060301)
辽宁省科技计划项目(2009415005)
关键词
功能配置评估
医学装备技术
聚类分析
组合赋权
临床路径
function deploying assessment
medical device technology
cluster analysis
combination weighting method
clinical pathway
