Study On The Assessment Indicators System Of Medical Quality Of Disease Types And Its Intervention Strategy Based On The Clinical Pathway

ObjectiveThis study uses analysis of factors Affecting medical expenses and Delphi to identity the key factor and key links Affecting medical quality ,combining standards Diagnosis and treatment models of clinical pathway .Thus a assessment indicators system of medical quality of disease types can be formed.This system makes medical quality management directly, specifically implemented in the course of the Diagnosis and treatment.At the same time, it can Analysize the causes of medical defects and targeted to improve. The assessment indicators system of medical quality of disease types provided basis for standardization of medical practice of hospital departments and quantitative indicators for the evaluation of general hospitals.It become a tool for improving and evaluating the quality of hospitals.Method1.Documentary method: look up both domestic and international documents on the threory of clinical pathway, assessment indicators system of medical quality.2.Consult experts by questionnaire to identify the weights and standard system for assessment of medical quality.3.Questionnaire: questionnaire was used to collect that data of the indicators for assessment of medical quality.4.Consult experts by discussion to study on the intervention strategy.5.Statistics: Set up database with Microsoft Office Excel 2003 and further calculate SPSS12.0 was used for statistical analysis and especially linear regression analysis was performed.Results1.The analysis of key factors Affecting medical expenses of disease types.Set simple VSD and Cesarean section as examples, identify the key factoes affecting medical expenses of simple VSD and Cesarean section.The key factors affecting medical expenses of simple VSD are:blood transfusion fees, costs of supplies during surgery, surgery fees, drugs fees during surgery, drugs fees after surgery, drugs ration, inspections ration, ration of supplies during surgery, the days and types of antibiotic treatment before surgery, days prior to the surgery. The key factors affecting medical expenses of simple Cesarean section are:inspections fees before surgery, surgery fees, anesthesia fees, disposal fees during surgery, inspections fees after surgery, diagnosis and treatment fees after surgery ,drugs ration, inspections ration. Therefore, a assessment indicators system of medical quality of different disease types should include different key factors which reflects the characteristics of disease types what can ensure the scientific and rationality of assessment.2.Establishing a assessment indicators system of medical quality of disease types.The tier 1 indicators of assessment of simple VSD and Cesarean section are: medical expenses, days of hospitalization , reasonable treatment, patient satisfaction. The tier 2 indicators of assessment of simple VSD are: costs of supplies during surgery, drugs fees during surgery, drugs fees after surgery, drugs ration, inspections ration, ration of supplies during surgery, the days of antibiotic treatment after surgery, days prior to the surgery, diagnosis and treatment fees after surgery, hours of intensive care, numbers of blood gas analysis, hours of continued monitoring ambulatory blood pressure, attitude for medical service, service process, diagnosis and treatment efficacy, the implementation of health education. The tier 2 indicators of assessment of simple Cesarean section are: inspections fees after surgery, disposal fees during surgery, diagnosis and treatment fees after surgery ,drugs ration, inspections ration, drugs fees after surgery, days after surgery, ration of supplies during surgery, the days and types of antibiotic treatment after surgery, attitude for medical service, service process, diagnosis and treatment efficacy, the implementation of health education.3.Study on the intervention strategy.(1)Using the assessment indicators system of medical quality of disease types to play Real-time control, including process improving, continuous improvement and preventive improvement of medical qulity(.2)Analysizing the medical defects and tgrgeted improvement.(3)Form an effective incentive and restraint mechanismsConclusions1.The assessment indicators system of medical quality of disease types is comprehensive quality management including controls of medical technology quality, service quality, patient satisfaction and quality costs.2.The assessment indicators system of medical quality of disease types stressed the process control because the formation of it is based on the standards Diagnosis and treatment models of clinical pathway.3.The assessment indicators system of medical quality of disease types fouces on the characteristics of treatment processes and cost structures of different disease types which reflects the difference.4.The assessment indicators system of medical quality of disease types provided basis for standardization of medical practice of hospital departments and quantitative indicators for the evaluation of general hospitals.It become a tool for improving and evaluating the hospital management.5.The assessment indicators system of medical quality of disease types provides reference standards for supervision and inspection of the department of medical institutions which is a need for medical insurance reform.