摘要
目的探究计划(plan,P)-执行(do,D)-研究(study,S)-行动(act,A)循环法在公立医院规范手术收费中的实践研究。方法选取2020年3月—2023年11月惠州市中心人民医院22374份病历或费用清单为研究对象,按照PDSA循环法实施前后分为2部分,实施前2020年3月—2021年6月病历或费用清单共计11145份,实施后2021年7月—2023年11月病历或费用清单共计11229份。研究以现行的临床诊疗规范与价格政策为基础,运用PDSA循环法,分析实施效果。另选取实施前后手术患者各120例,调查患者满意度。结果实施后手术收费准确率为98.01%,高于实施前的78.58%,差异有统计学意义(P<0.05);实施后,收费项目不明确或描述模糊、未执行项目但已收费、一次性耗材计价错误、其他问题发生率分别为0.22%、0.28%、0.17%、0.13%,实施前分别为4.07%、2.31%、2.78%、0.69%,实施后医院各手术收费问题发生率低于实施前,差异均有统计学意义(P<0.05)。实施后,患者满意度为(9.26±0.44)分,实施前为(8.58±0.37)分,实施后高于实施前,差异有统计学意义(P<0.05)。结论基于PDSA循环法可以规范公立医院手术收费,减少手术收费问题发生,保证患者对手术收费情况的满意程度。
Objective To explore the practical study of the plan-do-study-act(PDSA)cycle in standardizing surgical charges in public hospitals.Methods A total of 22,374 medical records or expense lists from Huizhou Central People’s Hospital from March 2020 to November 2023 were selected as the research subjects.There were 11,145 medical records or expense lists from March 2020 to June 2021 before implementation,and 11,229 medical records or expense lists from July 2021 to November 2023 after implementation.Based on current clinical diagnosis and treatment standards and pricing policies,using PDSA circulation method as a means,analyze the implementation effect.Another 120 surgical patients were selected respectively before and after the implementation,and their satisfaction was investigated.Results After implementation,the accuracy rate of surgical charges was 98.01%,which was higher than 78.58%before implementation,with a statistically significant difference(P<0.05).After implementation,the incidence rates of unclear or vaguely described charge items,charges for unperformed items,pricing errors of disposable consumables,and other problems were 0.22%,0.28%,0.17%,and 0.13%respectively,compared with 4.07%,2.31%,2.78%,and 0.69%before implementation.The incidence rates of various surgical charge problems in the hospital after implementation were lower than those before implementation,and all differences were statistically significant(P<0.05).After implementation,the patient satisfaction score was(9.26±0.44)points,which was higher than(8.58±0.37)points before implementation,with a statistically significant difference(P<0.05).Conclusion The PDSA cycle method can standardize surgical fees in public hospitals,reduce the occurrence of surgical fee problems,ensure patient satisfaction with surgical fee situations.
作者
钟勇辉
张琼瑜
刘秋娜
ZHONG Yonghui;ZHANG Qiongyu;LIU Qiuna(Department of Hospital Development,Huizhou Central People’s Hospital,Huizhou Guangdong 516000,China)
出处
《中国卫生标准管理》
2025年第14期61-64,共4页
China Health Standard Management
基金
惠州市科技计划项目(2024CZ010118)。
关键词
公立医院
规范手术收费
PDSA循环法
收费准确率
手术费用
满意度
public hospitals
standardize the operation fees
PDSA cycle method
charging accuracy
surgical fees
satisfaction
