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基于 TOPSIS 和 RSR 方法的三级甲等中医医院医疗质量特征。

Characteristics of Medical Quality in Tertiary Traditional Chinese Medicine Hospitals by TOPSIS and RSR Methods.

机构信息

School of Public Health, Lanzhou University, Chengguan District, Lanzhou, China.

Medical Department,Gansu Provincial Hospital of Traditional Chinese Medicine, Qilihe District, Lanzhou, China.

出版信息

Inquiry. 2024 Jan-Dec;61:469580241275324. doi: 10.1177/00469580241275324.

Abstract

Performance evaluation is important for improving medical quality and services. But, there is a lack of research for medical quality in traditional Chinese medicine (TCM) hospitals. This study examines the medical quality and various indicators of tertiary public traditional Chinese medicine hospitals in Gansu Province, to establish a foundation for improving the medical and management standards of these hospitals. This study collected performance assessment data from 10 tertiary TCM hospitals in Gansu Province from 2019 to 2022. Thirteen indicators with TCM characteristics were selected and categorized into 3 aspects: control of medical costs, internal operational dimensions, and comprehensive management. The level of medical quality in different hospitals and in different years were determined using the TOPSIS method for ranking and the RSR method for grading. Firstly, in terms of TCM characteristic indicators, hospital H had the highest control of medical costs and comprehensive management among different hospitals, with 45.87% and 24.20% respectively. The highest values for control of medical costs and comprehensive management were observed in 2020, with 40.65% and 18.69% respectively among different years. When evaluating the medical quality of different hospitals using the TOPSIS method, it was found that hospital H had the highest ranking from 2020 to 2022, with values of 0.725, 0.778, and 0.667 respectively. Additionally, the RSR method indicated that hospital H had a high level of grading from 2020 to 2022, with values of 0.687, 0.690, and 0.723 respectively. These findings suggest that the medical quality of hospital H is at a high and stable level of development. Based on the TOPSIS method to evaluate the performance appraisal results and ranking of different hospitals from 2019 to 2022. The results showed that the highest ranking was hospital B(C = 0.913) in 2019. The highest ranking was hospital C(C = 0.809)in 2020. The highest ranking was hospital D(C = 0.689) in 2021. The highest ranking was hospital J(C = 0.865) in 2022. The RSR method indicated that high grading level were hospitals B(P = 0.899),F(P = 0.795) in 2019. The highest grading level was hospital C(P = 0.809) in 2020. The highest grading level were hospitals A(P = 0.868), D(P = 0.813), E(P = 0.689), G(P = 0.873), J(P = 0.813), K(P = 0.842) in 2022. Based on the above results indicate that there is a large variation in the medical quality profile of different hospitals from 2019 to 2022. By comparing the results of TOPSIS and RSR method from 2019 to 2022, we found that the hospitals with identical ranking were D and J, and the hospitals with ≤2 difference in ranking was A,B,C,E in 2019, the hospitals with >2 ranking was A, F in 2020, the hospitals with >2 ranking were C, G in 2021, and the hospitals with identical ranking results were B,D,E,G,J in 2022. Comparing the ranking results of TOPSIS and RSR methods, showed that the hospitals with identical rankings were B, F from 2019 to 2022. The difference in ranking results ≤2 were A, C, D, E, G, H, J, K, indicating that high consistency between TOPSIS and RSR methods and credible results. The findings reveal significant fluctuations in medical quality across different years, while the overall level of medical quality remains relatively stable among the various hospitals. It is recommended that TCM hospitals focus on improving management efficiency, optimizing hospital operations, enhancing the utilization of medical resources, and fostering the efficient development of hospitals.

摘要

绩效评估对于提高医疗质量和服务水平至关重要。然而,传统中医(TCM)医院的医疗质量研究相对较少。本研究旨在评估甘肃省三级公立中医医院的医疗质量和各项指标,为提高这些医院的医疗和管理水平奠定基础。

本研究收集了甘肃省 10 所三级中医医院 2019 年至 2022 年的绩效评估数据。选取了 13 项具有中医特色的指标,并将其分为三个方面:医疗成本控制、内部运营维度和综合管理。采用 TOPSIS 法进行排名和 RSR 法进行分级,确定不同医院和不同年份的医疗质量水平。

首先,在中医特色指标方面,医院 H 在不同医院中医疗成本控制和综合管理方面得分最高,分别为 45.87%和 24.20%。不同年份中,医疗成本控制和综合管理的最高值分别出现在 2020 年,分别为 40.65%和 18.69%。采用 TOPSIS 法评估不同医院的医疗质量时,发现医院 H 在 2020 年至 2022 年的排名最高,分别为 0.725、0.778 和 0.667。此外,RSR 法表明,医院 H 在 2020 年至 2022 年的分级水平较高,分别为 0.687、0.690 和 0.723。这些发现表明,医院 H 的医疗质量处于较高且稳定的发展水平。

基于 TOPSIS 法对 2019 年至 2022 年不同医院的绩效评估结果和排名进行评估。结果表明,2019 年排名最高的是医院 B(C=0.913),2020 年排名最高的是医院 C(C=0.809),2021 年排名最高的是医院 D(C=0.689),2022 年排名最高的是医院 J(C=0.865)。RSR 法表明,2019 年分级水平较高的是医院 B(P=0.899)和 F(P=0.795),2020 年分级水平较高的是医院 C(P=0.809),2021 年分级水平较高的是医院 A(P=0.868)、D(P=0.813)、E(P=0.689)、G(P=0.873)、J(P=0.813)和 K(P=0.842),2022 年分级水平较高的是医院 B、D、E、G 和 J。

以上结果表明,不同医院的医疗质量状况在 2019 年至 2022 年期间存在较大差异。通过比较 2019 年至 2022 年 TOPSIS 和 RSR 方法的结果,我们发现,在 2019 年,D 和 J 医院的医疗质量排名相同,而在 2020 年,A、B、C、E 医院的医疗质量排名差异不超过 2 分。

比较 2019 年至 2022 年 TOPSIS 和 RSR 方法的排名结果,发现 B 和 F 医院在 2019 年至 2022 年的排名相同,A 和 F 医院在 2020 年的排名差异超过 2 分,C 和 G 医院在 2021 年的排名差异超过 2 分,B、D、E、G 和 J 医院在 2022 年的排名相同。比较 TOPSIS 和 RSR 方法的排名结果,发现 B 和 F 医院在 2019 年至 2022 年的排名相同,A、C、D、E、G、H、J 和 K 医院的排名差异不超过 2 分,表明 TOPSIS 和 RSR 方法之间具有高度一致性,结果可信。

研究结果表明,不同年份的医疗质量存在显著波动,但各医院的整体医疗质量水平保持相对稳定。建议中医医院注重提高管理效率、优化医院运营、加强医疗资源利用,促进医院的高效发展。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/68f5/11406598/4d5f13c3408f/10.1177_00469580241275324-fig1.jpg

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