三级医院医疗质量评价指标体系的构建及优化

目的 在原有医疗质量评价体系的基础上，建立一套科学合理、可操作性强的三级综合性医院医疗质量评价指标体系。方法 采用典型研究方法，通过文献研究筛选初始指标，通过知情人访谈法确定质量评价框架，运用德尔菲法并借鉴平衡积分卡的原理和思想优化并确定指标及权重系数。结果 确定了以医疗基础质量、环节质量和终末质量为基本结构的三级综合性医院质量评价框架和指标体系，由3个一级维度、8个二级维度、24个三级维度指标体系及其相应权重。结论 医疗质量评价指标体系关注医院质量管理中的难点和重点环节，能够满足上海市三级综合性医院医疗质量管理的实际需要。

Research on the Construction and Optimization of Medical Quality Evaluation Indicators of Tertiary Hospital in Shanghai

Objective To develop a set of scientific and operational indicators for assessing medical quality of tertiary hospital based on the primary medical quality evaluation system. Methods Through literature study to compare the different hospital quality evaluating models at home and abroad and to identify the original index database. Focus group method was applied to select the quality evaluating model, Delphi methods was adopted to select indicators and their weight by using the balanced score card (BSC) theory. Results The quality evaluation model has 3 dimensions, including medical structural quality, process quality and outcome quality. Tertiary hospital quality evaluation model is established, which is composed of 3 first level indicators, 7 second level indicators and 28 third level indicators as well as their weighing systems. Conclusion The quality evaluation model paid close attention to the indicators reflecting the key areas of quality concern. It will meet the practical need of county hospital for carrying out quality management and control in Shanghai tertiary hospital.