摘要
目的探讨某三级甲等(三甲)医院医疗联合体(医联体)对所属社区医院经济效益和业务水平的影响,对目前医联体模式下的运行机制进行分析总结,为推广医联体模式提供建议。方法收集某三甲医院及其所属的社区医院实行医联体模式及开展该模式前后[2016年(实施前)及2017年(实施后)]的经济效益及业务水平相关数据,并分析两者之间的差异。对实施前后所有患者进行分层抽样后收集患者情况,并进行调查随访,分析其满意度和依从性。结果实施医联体以后,社区医院业务总收入量较实施前同期增加25.13%(267.12万vs.213.47万元),门诊人数增加15.55%(7496 vs.6487例),住院人数增加59.49%(1673 vs.1049例),而进修人次增长幅度最大[366.67%(14 vs.3人次)]。分层抽样后,共纳入患者472例,实施前213例,实施后259例;两组患者一般资料比较,差异均无统计学意义(P>0.05)。实施后患者的就诊满意度与依从性均优于实施前(P<0.05)。2017年6月及12月医护人员业务考试水平较2016年同期显著上升(t=-7.467、-9.998,P<0.001),且2017年12月成绩显著高于2017年6月(t=-4.719,P<0.001);2016年6月与12月业务水平考核成绩比较,差异无统计学意义(t=-1.158,P=0.250)。结论有效的医联体"三建一管模式"能促进社区医院医疗水平进步的同时还能促进其经济效益有效提升,提高患者就诊满意度。
Objectives To explore the impact of the medical consortium of a tertiary grade A hospital on the economic benefits and business levels of the community hospitals,to summarize the problems of the current medical joint mode,and to provide suggestions for promoting the medical association model.Methods We collected the data of economic benefit and business level of a tertiary grade A hospital and its affiliated community hospitals before and after the implementation of the medical consortium model[2016(pre-implementation)and 2017(post-implementation)],and analyzed the differences between the two groups.Patients were selected by stratified sampling method before and after the implementation,investigations and follow-up were conducted.The satisfaction and compliance were analyzed.Results Compared with the data in 2016,in 2017,the total income of community hospitals increased by 25.13%(2.6712 million yuan vs.2.1347 million yuan),the number of outpatients increased by 15.55%(7496 vs.6487 cases),the number of hospitalizations increased by 59.49%(1673 vs.1049 cases),and the number of students increased the most,reaching366.67%(14 vs.3).Finally,a total of 472 patients were included,including 213 in pre-implementation group and 259 in post-implementation group.There was no significant difference in the general data between the two groups(P>0.05).The patients’satisfaction and compliance in post-implementation group were better than those in pre-implementation group(P<0.05).In June and December 2017,the hospital’s medical staff business test level increased significantly compared with those in the same period in 2016(t=-7.467、-9.998,P<0.001),and the results in December 2017 were significantly higher than those in June 2017(t=-4.719,P<0.001).But there was no significant difference in the performance of business level assessment between the results in June 2016 and in December 2016(t=-1.158,P=0.250).Conclusion An effective"Three Construction and One Management"model can promote the advancement of medical standards in community hospitals while promoting the effective improvement of economic benefits and improving the patients’satisfaction.
作者
凌蔚
梅松竹
郭鹏
LING Wei;MEI Songzhu;GUO Peng(Sichuan Provincial Health Service Guidance Center,Chengdu,Sichuan 610041,P.R.China;Maternal and Child Health Family Planning Service Center of Kunming City,Kunming,Yunnan 650000,P.R.China;Sichuan Provincial Cancer Hospital Specialist Alliance Management Office,Chengdu,Sichuan 610041,P.R.China)
出处
《华西医学》
CAS
2020年第7期855-859,共5页
West China Medical Journal
基金
四川省科学技术厅重点研发项目(2019YFS0031)。
关键词
医疗联合体
三级甲等医院
社区医院
经济效益
业务水平
Medical consortium
Tertiary grade A hospital
Community hospitals
Economic benefits
Business level
