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目的对专科医院实施主诊医师负责制进行效果评价,探讨主诊医师负责制在专科医院乃至地区实施的可行性。方法选择试点科室及对照科室,收集医疗数量或质量、医疗效率或效益及人力资源指标,并参照医院季度患者满意度问卷调查数据,运用SAS统计软件对这些数据进行描述、分析。结果试点科室实施前后多项指标经SAS统计分析提示如门急诊量、出院患者数量、住院治愈好转率、抗菌药物使用率、平均住院日、床位周转次数、住院次均费用均显著改善,差异具有统计学意义。试点科室和对照科室实施前后指标差值经SAS统计分析,提示试点科室的门急诊量、出院患者数量、住院次均费用改善程度更明显。试点科室实施前后,医疗服务总满意率提高0.19%,住院护理总满意率提高3.62%,有效投诉量减少5起。结论主诊医师负责制的实施,促进了医疗质量和工作效率的提高,有利于改善医患关系,减少医疗纠纷的发生,降低患者医疗负担,提高医疗服务满意度;主诊医师负责制在专科医院试点,已经从多方面体现出它的先进性和科学性,具有应用及推广的可行性及价值。
Objective To evaluate the effect of the chief physician responsibility system in specialist hospitals and to explore the feasibility of the chief physician responsibility system in the implementation of specialist hospitals and even the regions. Methods The pilot departments and control departments were selected to collect the medical quantity or quality, medical efficiency or benefit and human resource index, and the SAS quarterly patient satisfaction questionnaire survey data were used to describe and analyze the data with SAS statistical software. Results A number of indicators before and after the implementation of the pilot project were significantly improved by SAS statistical analysis such as the number of outpatient and emergency visits, the number of patients discharged, the rate of hospitalization improvement, the rate of antibiotic use, the average length of stay, the number of bed turnover and the average cost of hospitalization. Statistical significance. Pilot departments and control departments before and after the implementation of indicators of the difference between the SAS statistical analysis, suggesting that the pilot department emergency room volume, the number of patients discharged, the average cost of hospitalization more obvious improvement. Before and after the implementation of pilot departments, the total satisfaction rate of medical service increased by 0.19%, the total satisfaction rate of inpatient nursing increased by 3.62% and the effective complaint volume decreased by 5. Conclusion The implementation of the chief physician responsibility system promoted the improvement of medical quality and work efficiency, improved the relationship between doctors and patients, reduced the incidence of medical disputes, reduced the medical burden on patients and improved the satisfaction of medical services; The pilot of the hospital has demonstrated its advancedness and scientificalness in many aspects and has the feasibility and value of application and promotion.