【作者】 王卓；

【导师】 沈江；

【作者基本信息】 天津大学 ， 工程管理， 2010， 硕士

【摘要】 医疗风险是客观存在的,不会因医学进步而消除,不但给患者及其家属造成巨大的精神、生理、经济负担,也给医护人员开展正常医疗行为带来心理阴影。研究证明,一半以上的医疗不良事件都源于医疗系统。近年来频发的医疗不良事件引起了卫生部医政司与中国医师协会的高度关注,并于2005年召开会议探讨建立医疗风险管理的必要性、程序、评价体系,旨在建立医疗风险监测和预警机制。医疗风险管理理论和技术方法的相关研究在我国起步较晚,还处于被动学习和吸收国外研究成果的阶段。目前,国内对医疗风险管理已经细化到各类病症和各个科室的风险研究,但是这些研究局限于临床的具体应用,缺乏从医疗机构管理层面上对医疗风险的管理。本文试图从成熟的土木工程管理的理论和风险评价技术方面对医疗风险管理理论做新的理论突破和创新,以完善医疗风险管理理论。本文站在医疗机构管理者的角度,从医疗机构战略管理的高度对医疗风险管理进行研究。选取工程管理上的全生命周期风险管理理论用于医疗行业,作为医疗风险管理的指导思想。再用土木工程施工管理方法和工程项目管理思想分别对医疗风险进行分析和识别。随后,建立医疗风险的多评判因素三级评价指标体系,使用基于熵权的灰色可拓物元评判模型对医疗风险定量分析。在模型中,用熵值法确定各个风险权重,最大程度减少主观影响;并用灰色系统理论模拟评价指标之间的关联性和影响性;用可拓评判数学模型确定风险值。将此模型应用于实际医疗机构的管理案例,可以对医疗风险定量分析、评价并排序。最后,对医疗风险的处置和分担机制做了介绍,并且对医疗风险管理研究的趋势做出了展望。更多还原

【Abstract】 Medical risks are impersonal and can’t be eliminated completely by medical progress. Medical risks not only cause great mental, physical, economic burden to patients and their familys, but also interfere medical group with the normal medical activities. Research shows that more than half of the medical adverse events are due to medical system itself. In recent years, frequent medical adverse events attract Department of Medical Administration and China Physicians Association’s attention. In order to discuss the necessity of the medical risk management and management procedure, Department of Medical Administration and China Physicians Association held a meeting in 2005 to establish medical risk monitoring and warning mechanism.Related research of medical risk management theory and techniques started late in our country. So we still in the stage of passive learning and absorbing foreign research results. At present, medical risk management have refined out much according to hospital departments and disease types. However, it confined to specific application of clinical medical risk management and lack of medical risk management from from the enterprise strategic height. This article attempts to make a new theory and innovation by making use of construction management theory and risk assessment technology.This thesis studied medical risk management from the view of medical institutions managers at the enterprise management level. The whole life cycle of risk management theory is used in medical profession as the guiding ideology of medical risk management. Then medical risks are analyzed by construction site management methods. Medical risks are identified by project management thoughts.Subsequently, multiple-evaluation-factor indexes system of three levels and the grey extension evaluation model based on entropy weight are used to analyze medical risks quantitatively. In this model, the entropy method is used to determine the each risk’weight for eliminating the subjective factors and the grey system theory is used to simulate real risks to the greatest extent.This model used in the actual case can analyze and assesse medical risks and arrange risks in priority order. Finally, this thesis introduces medical risk disposition and sharing mechanism and prospects the trend of research of medical risk management.更多还原