摘要
目的:基于以资源为基础的相对价值比率(RBRVS)理论框架,建立我国胃肠外科医疗项目的医师工作量相对值表。方法:利用专家咨询法确定胃肠外科调查项目与基准项目,受访医师用量值估计法同时填答总工作量和耗用时间以及脑力判断、技术与体力、心理压力等维度的相对值,现场观察法对数据进行验证,对问卷数据进行描述性统计和推断性统计。结果:共获得胃肠外科20项医疗项目的医师工作量相对值和耗用时间;问卷结果信效度良好,克朗巴哈信度系数均高于0.8,斯皮尔曼-布朗系数多数高于0.8,耗用时间、脑力判断、技术体力和心理压力四个维度对医师工作量的解释力度高达0.994;相比其他三个维度,耗用时间与医师工作量的相关系数较低;胃肠外科内部存在给付不平衡现象。结论:消耗时间、脑力判断、技术体力和心理压力四个维度,是良好的医师工作量预测工具;本研究在信效度良好的基础上建立20项本土胃肠外科医师工作量相对值表;发现胃肠外科部分项目存在给付不合理现象。
Objective:To set up the workload relative value scale of gastrointestinal surgery treatments based on the theoretical framework of Resource-Based Relative Value Scale(RBRVS).Methods:The survey items of gastrointestinal surgery and the benchmark project were determined by the expert consultation method,and the gastrointestinal surgeons answered the questionnaires of relative values of total workload as well as time,mental effort and judgment,technical skill,level of stress with the method of magnitude estimation,and the field observation method was used to verify and supplement the data,descriptive statistics and inferential statistics were conducted for the questionnaire data.Results:The physician workload relative value scale and time for 20 gastrointestinal surgery treatments was obtained.Reliability and validity of the questionnaire results were satisfactory,with Cronbach’s Alpha coefficient as higher than 0.8,and most spearman-brown coefficient as higher than 0.8,and the correlation coefficient between the four aspects of time consumption,mental effort and judgment,technical skill and level of stress and the total workload was as high as 0.994.The correlation coefficient between the time consumed and the workload was lower than the other three dimensions.The payment of most treatments increased with the increase of workload,but some were deviated from the trend line,and the payment was unreasonable.Conclusion:It proved that physician time,mental effort and judgment,technical skill and level of stress were effective tools to evaluate the physician workload.The physician workload relative value scale for 20 gastrointestinal surgery treatments was established based on good reliability and validit.The payment of some procedures of gastrointestinal surgery was unreasonable.
作者
杜芳
石骄阳
薛镭
邱亨嘉
DU Fang;SHI Jiao-yang;XUE Lei(Institute of Hospital Management,Tsinghua University,Shenzhen,Guangdong,518055,China)
出处
《中国卫生经济》
北大核心
2019年第11期68-71,共4页
Chinese Health Economics
基金
清华大学泰禾科研基金项目（0402010001）
