上海市综合医院骨科高难度手术绩效分析

目的 研究上海市级综合性医院体现骨科技术水平的高难度手术绩效.方法 采用描述性统计分析、类比分析和专家咨询的方法进行研究.结果 经专家评议,上海市18家综合性医院筛选出11种高难度骨科手术,共计4 481例(5.65%);脊柱外科病例最多,为2 121例(47.33%);A医院病例最多,为1 399例,占分析病例的31.22%;按亚专科分类的出院均次费用为42 615~85 770元,平均住院日为6.5~16.36天,术前等待时间差别不大;医院层面的均次费用为36 863~92 001元,药占比为6.94%~21.21%,平均住院日为7.75~23.2天.结论 在骨科高难度手术方面,A医院的创伤外科、关节镜外科和关节外科,以及B医院的脊柱外科处于较为领先的地位;各医院手术绩效差异较大,部分医院还有改进空间.

Study on the Performance of Complicated Orthopedic Surgeries in Comprehensive Hospitals in Shanghai

Objective To analyze the performance of complicated orthopedic surgeries in comprehensive hospitals in Shanghai.Methods Methods of questionnaire survey, analogy analysis and expert interviews were adopted for the study.Results A total of 4481 cases in 11 kinds of complicated orthopedic surgeries were selected from 18 comprehensive hospitals, among which spine surgery accounted for 47.33%.Hospital A had a total of 1399 cases, accounted for 31.22%.The average cost per admission was between RMB 42,615 to 85,770 according to sub-discipline;the average length of stay was 6.5 to 16.36 days;and there is little difference in the preoperative waiting days.At the hospital level , the cost per admission ranged from RMB 36,863 to 92,001;the drug proportion was 6.94% to 21.21%;and the average length of stay was 7.75 to 23.2 days.Conclusion In terms of complicated orthopedic surgeries, Hospital A was in a leading position in trauma surgery, joint surgery and arthroscopic surgery, and hospital B was in a leading position in spine surgery.There is a big gap in the performance of complicated orthopedic surgeries between different hospitals and much room for improvement to some hospitals.