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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,为政府及全院范围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。
Objective To compare the indicators of work efficiency, quality of work and medical service before and after the implementation of the pre-doctor’s responsibility system in a special hospital through retrospective survey and analysis, and provide evidences for the promotion of the responsibility system of the attending physicians within the government and the whole hospital. Methods One TB department, one oncology department, two extra-thoracic and comprehensive subjects were selected as the chief physicians and the retrospective analysis was made on the statistical data of the pilot physicians responsible for the pilot system and the previous year. Results The implementation of the doctor in charge of the system: (1) a number of medical indicators improved significantly, the growth in parentheses data. The number of outpatients (39.56%), discharges (17.79%), bed occupancy rate (8.00%), drug susceptibility rate (41.00%), appointment rate of visits (28.60% , Patient satisfaction (5.00%), (2) part of the medical indicators improved significantly, the parentheses for the decline in data. The average length of hospital stay (2.38 days), nosocomial infection rate (0.20%), inpatient antibacterial drug use rate (24.24%), outpatient mean cost (27.90 yuan) and hospitalization average cost (305.69 yuan). Conclusion The implementation of post-doctor physicians responsibility for post-service medical work efficiency, quality of medical services, management quality and patient satisfaction have significantly increased, it is worth introducing and promoting.