基于TOPSIS的分级诊疗实施效果评价研究—以湖南省某市为例

目的 以湖南某市为例,评价分级诊疗政策在我国实施的效果,并讨论实际运行过程中的障碍及其解决对策。 方法 从该市分级诊疗试点工作信息上报平台中提取2015—2020年的分级诊疗实施效果相关指标,采用较理想解排序法(technique for order preference by similarity to ideal solution,TOPSIS)对该市实行分级诊疗政策的实施效果及进展情况作综合评价。 结果 从2015—2020年,Ci值依次为0.046、0.062、0.295、0.363、0.759、0.913,该市的分级诊疗运行情况数据评价得分Ci逐年提高,2015年该市分级诊疗实施效果最不明显,2020年最为明显。 结论 该市的分级诊疗实施效果显著,但仍存在着医疗卫生机构职能定位不明确和基层医疗卫生机构发育迟缓的问题,需要继续加大政府的宏观调控作用,加强基层医疗卫生机构的能力建设和切实利用好“互联网+医疗”。

Evaluation on implementation effect of hierarchical diagnosis and treatment based on TOPSIS-taking a city in Hunan Province as an example

Objective Taking a city in Hunan Province as an example, this study evaluated the effect of hierarchical diagnosis and treatment policy in China, and discussed the obstacles in the actual operation process and related countermeasures. Methods The indicators related to implementation effect of hierarchical diagnosis and treatment in 2015-2020 were extracted from the city’s information reporting platform for the pilot work of hierarchical diagnosis and treatment. The technique for order preference by similarity to ideal solution (TOPSIS) method was used to comprehensively evaluate the implementation effect and progress of hierarchical diagnosis and treatment policy in the city. Results From 2015 to 2020, the Ci values were 0.046, 0.062, 0.295, 0.363, 0.759 and 0.913, respectively. The Ci score of operation data evaluation of hierarchical diagnosis and treatment in the city increased year by year. The implementation effect of hierarchical diagnosis and treatment in the city was the most unnoticeable in 2015, but the most obvious in 2020. Conclusion The implementation effect of hierarchicaldiagnosis and treatment in the city is remarkable, but there are still some problems such as unclear functional orientation of medical and health institutions and stunted development of grass-roots medical and health institutions. It is necessary to continue to increase the government’s macro-control role, strengthen the capacity building of primary medical and health institutions, and make good use of “Internet + medical care”.