發(fā)布時(shí)間：2018-05-11 03:40

  本文選題：區(qū)級(jí)婦幼保健院 + 兒科��； 參考：《廣州中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:在了解廣州市兒科醫(yī)療服務(wù)概況和區(qū)級(jí)婦幼保健院兒科醫(yī)療服務(wù)現(xiàn)狀的基礎(chǔ)上,構(gòu)建廣州市區(qū)級(jí)婦幼保健院兒科醫(yī)療服務(wù)能力評(píng)價(jià)指標(biāo)體系,基于構(gòu)建的評(píng)價(jià)指標(biāo)體系對(duì)廣州市區(qū)級(jí)婦幼保健院兒科醫(yī)療服務(wù)能力進(jìn)行綜合評(píng)價(jià),分析廣州市區(qū)級(jí)婦幼保健院兒科醫(yī)療服務(wù)能力建設(shè)中存在的問(wèn)題,并提出提升廣州市區(qū)級(jí)婦幼保健院兒科醫(yī)療服務(wù)能力的建議,為衛(wèi)生行政管理部門的決策提供參考依據(jù)。方法:采用問(wèn)卷調(diào)查法收集廣州市兒科和區(qū)級(jí)婦幼保健院兒科的相關(guān)數(shù)據(jù),采用文獻(xiàn)研究法、德?tīng)柗品?gòu)建廣州市區(qū)級(jí)婦幼保健院兒科醫(yī)療服務(wù)能力的評(píng)價(jià)指標(biāo)體系;采用AHP層次分析法測(cè)算各級(jí)指標(biāo)權(quán)重;采用Topsis法對(duì)廣州市區(qū)級(jí)婦幼保健院進(jìn)行綜合評(píng)價(jià)。結(jié)果:1.廣州市兒科醫(yī)療服務(wù)總體情況:共110家醫(yī)療機(jī)構(gòu)開(kāi)展兒科業(yè)務(wù),醫(yī)護(hù)比為1:1.26,高學(xué)歷高職稱兒科醫(yī)生多集中在三級(jí)醫(yī)療機(jī)構(gòu),兒科醫(yī)務(wù)人員收入低于全院平均水平,兒科醫(yī)生平均工作量高于全院。2.廣州市區(qū)級(jí)婦幼保健院兒科醫(yī)療服務(wù)現(xiàn)狀:醫(yī)生數(shù)從2013年的147人降為2015年的140人,護(hù)士數(shù)則先從2013年的272人增長(zhǎng)為2014年的281人,到2015年下降為271人;以2015年為例,醫(yī)生:高級(jí)職稱以上占比20%,碩士學(xué)歷占比8%,護(hù)士:中級(jí)職稱以上占比約10%,本科以上學(xué)歷占比22%;2013到2015年,廣州市區(qū)級(jí)婦幼保健院兒科平均住院日下降,病床使用率增加,病床周轉(zhuǎn)次數(shù)下降。3.廣州市區(qū)級(jí)婦幼保健院兒科醫(yī)療服務(wù)能力評(píng)價(jià)指標(biāo)體系的構(gòu)建:采用專家咨詢法構(gòu)建了三級(jí)評(píng)價(jià)指標(biāo)體系,包括人力、物力、財(cái)力、醫(yī)療服務(wù)4個(gè)一級(jí)指標(biāo),人員數(shù)量、人員構(gòu)成、床位數(shù)等10個(gè)二級(jí)指標(biāo),科室醫(yī)護(hù)人員總數(shù)、每千人兒童醫(yī)生數(shù)、醫(yī)護(hù)比、本科以上醫(yī)生比例等24個(gè)三級(jí)指標(biāo)。4.廣州市區(qū)級(jí)婦幼保健院兒科醫(yī)療服務(wù)能力各級(jí)評(píng)價(jià)指標(biāo)權(quán)重的確定:基于構(gòu)建的指標(biāo)體系,采用AHP法測(cè)算了各級(jí)指標(biāo)的權(quán)重,權(quán)重最大的前三指標(biāo)為人力(0.4550)、人員構(gòu)成(0.3640)、財(cái)力(0.2627)。5.廣州市區(qū)級(jí)婦幼保健院兒科醫(yī)療服務(wù)能力的綜合評(píng)價(jià)結(jié)果:基于構(gòu)建的評(píng)價(jià)指標(biāo)體系和調(diào)查數(shù)據(jù),經(jīng)Topsis法排序,區(qū)級(jí)婦幼保健院中服務(wù)能力最好的是H3醫(yī)院,Ci值為0.7046,最差的是H1醫(yī)院,Ci值為0.1768。結(jié)論:1.兒科醫(yī)護(hù)人員總數(shù)不足,素質(zhì)有待提升;兒科醫(yī)護(hù)人員工作壓力大,流動(dòng)性高;兒科床位資源不能滿足患者需求;兒科醫(yī)護(hù)人員收入和付出比例失衡;兒科財(cái)政補(bǔ)償不足。2.建立了廣州市區(qū)級(jí)婦幼保健院兒科醫(yī)療服務(wù)能力三級(jí)評(píng)價(jià)指標(biāo)體系;采用AHP層次分析法測(cè)算了各級(jí)指標(biāo)權(quán)重;采用Topsis法對(duì)廣州市區(qū)級(jí)婦幼保健院兒科服務(wù)能力進(jìn)行綜合評(píng)價(jià),驗(yàn)證了評(píng)價(jià)指標(biāo)體系的可操作性。3.從政府、醫(yī)院、醫(yī)護(hù)人員、患者四方面提出提升廣州市區(qū)級(jí)婦幼保健院兒科醫(yī)療服務(wù)能力的對(duì)策:政府要重視兒童醫(yī)療衛(wèi)生事業(yè)的發(fā)展,增加對(duì)兒童醫(yī)療衛(wèi)生事業(yè)的投入,在區(qū)級(jí)婦幼保健院的基礎(chǔ)上加強(qiáng)兒童�？漆t(yī)院建設(shè);區(qū)級(jí)婦幼保健院醫(yī)院要重視兒科的發(fā)展,改革績(jī)效薪酬體系,建立兒科患者轉(zhuǎn)診機(jī)制;兒科醫(yī)護(hù)人員培養(yǎng)職業(yè)自信,提高自身服務(wù)能力,重視醫(yī)患溝通;患兒家長(zhǎng)要理性就醫(yī),給予兒科醫(yī)護(hù)人員更多的寬容和理解。
[Abstract]:Objective: on the basis of understanding the general situation of Guangzhou paediatric medical service and the current situation of pediatric medical service in the district level maternal and child health care hospital, the evaluation index system of the pediatrics medical service ability of the Guangzhou urban maternal and child health care hospital was constructed. Based on the evaluation index system, the pediatrics medical service ability of the urban maternal and child health care hospital of Guangzhou was evaluated comprehensively. This paper analyzes the existing problems in the capacity construction of Pediatrics medical service in Guangzhou urban maternal and child health care hospital, and puts forward some suggestions to improve the ability of pediatric medical service in Guangzhou urban maternal and child health care hospital, and provides a reference for the decision-making of the health administration department. Method: using the questionnaire survey method to collect the pediatrics of the pediatrics and the district level maternity and child health care hospital of Guangzhou Related data, using the literature research method, Delphi method to construct the evaluation index system of the pediatrics medical service ability of Guangzhou urban maternal and child health care hospital; use the AHP analytic hierarchy process to measure the index weight at all levels and the comprehensive evaluation of Guangzhou urban maternal and child health care hospital in Guangzhou. Results: 1. the general situation of the pediatrics medical service in Guangzhou City: A total of 110 medical institutions carried out pediatric operations. The medical care ratio was 1:1.26. The high academic and high professional pediatrician concentrated in the three level medical institutions. The income of paediatric medical staff was lower than the average level of the hospital. The average workload of pediatricians was higher than that of the hospital of.2. Guangzhou urban maternal and child health care hospital: the number of doctors dropped from 147 in 2013. For the 140 people in 2015, the number of nurses increased from 272 in 2013 to 281 in 2014, to 271 in 2015; in 2015, for example, doctors: higher professional titles and above 20%, master degree accounted for 8%, nurses: Higher Vocational titles than about 10%, undergraduate education and above 22%; 2013 to 2015, Guangzhou urban maternal and child health care hospital, Er Keping The decline of the hospitalization day, the increase of hospital bed use rate, the decrease of the number of bed turnover,.3. Guangzhou urban maternal and child health care hospital pediatric medical service evaluation index system construction: using the expert consultation method to construct the three grade evaluation index system, including manpower, material resources, financial resources, medical service 4 first level indicators, the number of personnel, personnel composition, bed number and so on 10 two level indicators, the total number of medical and nursing staff in the Department, the number of doctors and nurses per thousand, the ratio of medical care and nursing, and the proportion of doctors and children above the undergraduate level, 24 three level indicators.4., the weight of the evaluation index weight of the Department of Pediatrics medical service at Guangzhou city level maternal and child health care hospital: Based on the construction index system, the weight of the indexes at all levels is measured with the AHP method and the weight is the largest The first three indexes were human (0.4550), personnel composition (0.3640), financial (0.2627).5. Guangzhou urban maternal and child health care hospital comprehensive evaluation of the pediatrics medical service ability. Based on the evaluation index system and survey data, the best service ability in the district level maternal and child health care hospital was the H3 hospital, the Ci value was 0.7046, the worst was H1. The hospital, Ci value is 0.1768. conclusion: 1. the total number of paediatric medical staff is insufficient, the quality needs to be improved; paediatric medical staff work pressure and high mobility; paediatric bed resources can not meet the needs of the patients; the income and payment ratio of paediatric medical staff are unbalance; paediatric financial compensation is not sufficient.2. to establish the Guangzhou urban maternal and child health care hospital paediatric medical suits. The three level evaluation index system is used to measure the index weight of the three levels, and the Topsis method is used to evaluate the paediatric service ability of the Guangzhou urban maternal and child health care hospital, and the operability of the evaluation index system is verified by the four aspects of the government, hospital, medical staff and patients to improve the maternal and child health care in Guangzhou. The Countermeasures of the pediatric medical service ability of the hospital: the government should attach importance to the development of children's medical and health services, increase the investment in children's medical and health services, strengthen the construction of children's specialized hospitals on the basis of the district level maternal and child health care hospital; the district level maternal and child health care hospital should attach importance to the development of paediatrics, reform the performance compensation system and establish pediatric patients. The pediatrics and nursing staff cultivate professional self-confidence, improve their own service ability, and attach importance to the communication between doctors and patients. The parents of children should make rational medical treatment and give more tolerance and understanding to the paediatric medical staff.

【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R197.5

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