某专科医院实施主诊医师负责制后医疗质量评价分析

目的通过回顾性调查分析对某专科医院实施主诊医师负责制前后在工作效率、工作质量、医疗服务等指标进行比较，为政府及全院范嗣内推广主诊医师负责制提供依据。方法选择结核一科、肿瘤一科、胸外二科及综合科为主诊医师负责制试点科室，对实施主诊医师负责制试点后与前一年的统计数据进行回顾性分析。结果实施主诊医师负责制后：（1）多项医疗指标明显提高，括号中为增长数据。门诊人次（39．56％）、出院人次（17．79％）、床位使用率（8．00％）、药敏送检率（41．00％）、预约就诊率（28．60％）、临床路径入径例数（278个），患者满意度（5．00％），（2）部分医疗指标明显改善，括号中为下降数据。平均住院日（2．38天）、院感发生率（0．20％）、住院患者抗菌药物使用率（24．24％）、门诊次均费用（27．90元）、住院次均费用（305．69元）。结论实施主诊医师负责制后医疗工作效率、医疗服务质量、管理质量及患者满意度均有显著提高，值得引入并加以推广。

Evaluation Analysis on the Medical Treatment Quality after the Implementation of Attending Doctors Responsibility System in a Specialized Hospital

Objective To conduct a retrospective analysis on the indexes such as working efficiency, working quality and medical treatment service before and after the implementation of attending doctors responsibility system in a specialized hospital, and provide evi- dence for the promotion of the system in the scope of the Whole country. Method The first department of tuberculosis, the first depaltment of tumor, the second department of chest surgery and the general haedical department were chosen as the experimental units, and made a retrospective analysis on tlae statistical data before and after the implementation of the system for one year. Result After the implementation of attending doctors responsibility system, （ 1 ） Many indexes of medical treatment were increased obviously, the increased amount was in the bracket respectively, outpatient amount（39.56% ）, discharged amount （ 17.79% ）, bed usage rate（ 8.00% ）, drug allergy inspection rate （41.00%）, appointment rate（28.60% ）, enter rate of clinical pathway（278 cases）and satisfactory rate（5.00% ）. （2） Some of the indexes were improved obviously, the improved amount.was in the bracket respectively. Average length of stay （2.38 days）, infection rate within hospital（0.20% ）, usage rate of antibacterial agents（24.24% ）, average expense of outpatient department （27.90 RMB ）, average expense of inpatient department （305.69 RMB）. Conclusion The working efficiency, medical lreatment service quality, management quality and the satisfactory rate of patients were all improved obviously after the implementation of attending doctors responsibility system, which was worth of introduction and promotion.