【作者】 杨永利；

【导师】 何钦成；

【作者基本信息】 中国医科大学 ， 社会医学与卫生事业管理， 2006， 硕士

【摘要】 目的 建立一种用于医院综合效益评价的方法,使之能客观、科学、公正地评价医院综合效益,并简便易行,适于在基层医院推广使用。 方法 以五家改制或未改制的企业医院为研究对象,对其2002年至2004年的综合效益进行评价,确定了以医疗质量、工作效率、社会效益与经济效益、医疗规模等反映医院发展状况和水平的四个方面20个指标组成的综合效益评价体系,采用TOPSIS法与RSR法两种不同的统计学方法对各项指标进行统计学分析。首先,应用计算机EXCEL表格进行TOPSIS评价,建立评价指标的数据矩阵,采用倒数法和差值法将评价指标数据同趋势化,并使数据归一化。然后,确定指标的最优值和最劣值,分别构成最优值向量Z~+和最劣值向量Z~-,计算各评价单元指标值与最优值和最劣值的距离,计算各评价单元指标与最优值的相对接近程度(C值),按接近度大小对各评价单元优劣进行排序,C值越大,表明被评价对象越接近最优水平。采用RSR法进行评价时,平均住院日、药品收入占医疗收入比例按低优指标,其余按高优指标进行编秩。根据RSR法计算公式求出被评价对象的Y值,利用RSR的95%可信区间及图示作比较。对TOPSIS法和RSR法的评价结果进行了比较和分析。 结果 经采用TOPSIS法与RSR法两种不同的统计学方法对五家厂矿医院更多还原

【Abstract】 ObjectiveTo establish a system for evaluate synthetic benefit of the hospitals. With it we can not only make the evaluation to the synthetic benefits of hospitals more objectively and scientific and impartial, but also can judge the developmental state and level of hospitals so as to find the shortage and causes of the enterprise hospitals regardless of whether they had changed their operated mode. The results of evaluation may provide reference for the managers.MethodsWe first used the systems of TOPSIS (The Technique for Order Preference By Similarity to Ideal Solution) and RSR (Rank Sum Ratio) to evaluate synthetic benefit of the enterprise hospitals regardless of whether they had changed their operated mode. We established a synthetic benefit evaluation system that can reflect the developmental state and level of the hospitals and it is composed of 4 groups and 20 index including medical qualities, efficiency, social effects , economic returns ,medical scales and so on. We analyzed the data of all index with the systems of TOPSIS and RSR. We carried out TOPSIS evaluation with EXCEL software. We constructed data matrix and made them normalization through reciprocal or difference, Then we determined the optimal and inferior index that is optimal vector value Z~+ and inferior vector value Z~- and calculated the difference between the Z~+ and Z~- so to determine the Similarity between the optimal value and individual index. According to the similarity we sort of the e-valuation index and c represent the similarity with the optimal value. At last wetest the results with Rank Sum Ratio (RSR ) to make the the evaluation to the synthetic benefits of hospitals more scientific .ResultsWe processed the data of all 20 index from these hospitals through standardization and evaluation with TOPSIS and obtain a reasonable sorts to the hospitals according to their efficiency. Of the 5 coal - mine enterprise hospitals, 3 hospitals who had changed their operation mode have better synthetic benefits in the last 3 years and their index such as medical qualities , efficiency, social effects , economic returns , medical scales and so on improved obviously. The index of the other 2 hospital who had not changed their operation mode improve more slowly than the 3 hospital who had changed.ConclusionsWe have established an excellent system to evaluated the synthetic benefits and developmental state and level of the hospitals. The data were annual statistical numbers of the hospitals and collected easily. The process of TOPSIS was convenient and the coincidence of the results and the reality was excellent. All of these indicated that the system is objectively and scientific and impartial to e-valuated the synthetic benefits of hospitals. Testing the results with Rank Sum Ratio ( RSR ) can make the evaluation more scientific . The study has 4 outstanding features. The first, our work can consummate the internal study about the evaluation of the synthetic benefits of hospitals. The second, we first use TOPSIS to evaluated the difference of the synthetic benefits between the hospital who had changed operation mode and the hospitals who had not changed and presented that through changing operation mode the enterprise hospitals may develop more rapidly. The third, we provide the differences of these hospitals and analyzed the reasons so as to help the managers in the decision. The fourth, the system were composed of 4 groups and 20 index and it can overall reflect the developmental state and level. In short, the study was creative in the field of thehospital synthetic benefit evaluation but it should been test and consummated with larger samples study.更多还原