Construction and application of fourth-level surgery composite evaluation index of tertiary public hospitals: fourth-level surgery contribution degree
10.3760/cma.j.cn111325-20240315-00179
- VernacularTitle:三级公立医院四级手术复合评价指标的构建与应用：四级手术贡献度
- Author:
Juan YAN
1
;
Xiaoyu ZHAO
;
Hui DAI
;
Sheng HUANG
;
Weizhong ZHANG
;
Xiaodong WANG
Author Information
1. 南京医科大学第一附属医院医务处（应急办公室），南京 210029
- Keywords:
Fourth-level surgery;
Contribution degree;
Performance appraisal;
Weighting method;
Hospitals, public
- From:
Chinese Journal of Hospital Administration
2024;40(8):599-603
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To construct a composite evaluation index of fourth-level surgical, for references for horizontal comparison of fourth-level surgical between clinical departments of hospital and hospital performance appraisal.Methods:The data were extracted from the medical record information system and disease diagnosis related group information system of a tertiary public hospital, including the number of surgical patients, the number of fourth-level surgical patients, the case mix index (CMI), and the average length of hospital stay for 23 surgical departments from 2019 to 2023. Based on disease diagnosis related groups, the average length of hospital stay for patients undergoing fourth-level surgery was standardized to obtain the time cost index; Multiply the CMI and time cost index by the fourth-level surgical ratio to obtain the quality coefficient. This coefficient was used to weight the number of fourth-level surgeries to establish the contribution degree of fourth-level surgeries, which was used for the comprehensive evaluation of fourth-level surgery quality and quantity for each surgical department.Results:A total of 329 177 surgical patients were included in this study, including 139 704 patients with fourth-level surgery. From 2019 to 2023, the top 3 departments in terms of the proportion of fourth-level surgery were department J, B and A, and the proportion of fourth-level surgery in departments with high surgical difficulty, such as C and I, ranked 8th and 16th. The top 3 departments with the contribution degree of fourth-level surgery were department A, B and C, I rosed to the 9th, and J felled to the 11th.Conclusions:The fourth-level surgery contribution degree combined the four factors of surgical composition, difficulty, cost and quantity, which could objectively evaluate fourth-level surgeries in different departments.
