The medical quality cost of hospital of the first second and third is worth studying

The medical quality cost of hospital of the first, second and third is worth studying
In recent years, cost research and management of medical quality arouse the attention from administrator of domestic hospital gradually, optimize the structure of cost of medical quality, quality is optimum, the cost is reasonable, consume and obtain the greatest quality benefit with less quality, have become the modern medical quality administrator's common understanding gradually.
Public health institute Li Qian of medical university in Nanjing,et al. has issued in the 9th issue of 2010 of magazine of " Chinese hospital " >Article, point out the cost of medical quality refers to causing by technological quality defect of medical treatment at all expenses and hospital that the hospital pays in order to guarantee and improve the technological quality level of medical treatment Everything loss. The cost of medical quality is divided into the cost and medical quality loss cost of medical quality control. Among them the cost of quality control is divided into and prevented the cost and appraises the cost; Quality loses the cost and is divided into internal defective cost and external flawed or damaged cost.
Generally, it is related that it is mutual to exist between four projects of the cost of medical quality, according to the best quality cost model of the managerial expert Juran of U.S.A.'s quality, as preventing, appraising expenses when being few, there are getting lower very on quality level,inside or outside getting higher very,there are getting getting higher more very too in total cost on quality; Act as and prevent, determine the expenses increase gradually, quality level is improved gradually too, there are less defective loss and quality total cost gradually inside and outside; After reaching a certain level in quality, should improve, will cause and prevent, appraise the substantial increase of the cost, though the domestic and foreign defect is reduced, the total cost of quality rises continuously. Look from total cost curve of quality, quality level is when Qm checks, the total cost of quality is the lowest, Qm checks and checks as the best quality level, claims too the cost of best quality is checked.
The article regards hospital of some the first, second and third as the research object, through surveying this courtyard of medical quality cost states of 2006- 2008, is divided into to prevent the cost, appraises cost, internal defective cost and external defective cost the medical quality cost of this institute. Among them ( 1) It is mainly the organizational activities cost which is set up the medical quality management organization that medical treatment prevents the cost, " three bases three are tight " in management education of quality, training, activity expenses, the medical personnel With carry out, make a diagnosis regular training and examine expenses regularly, continue educating tuition, receive a training of, train fee,etc.; ( 2) Determine the cost is mainly the material qualification test expenses of all kinds of hygiene, the supply room sterilizes the qualified test expenses of articles, medical apparatus examine expenses, case history, prescription spot check, the intersection of quality and examine and the intersection of patient and the intersection of manpower and cost and other expense that satisfaction determine under courtyard, check and examine the expenses, institute's sense again and monitor the expenses and cure department's relevant quality of the skill to accuse of the expenses etc. clinically in medical link; ( 3) Internal defective cost mainly for caused by quality defect disinfection, detection, analyze, deal with expenses, medical fee that should be undertaken by the hospital because the patient emerging in quality defect treats repeatedly, project stopping, sick bed turnover of making a diagnosis that the quality defect initiates slows down the income caused to reduce, because violation is investigated and prosecuted, fined expenses,etc. in the medical quality control of the hospital; ( 4) The external defective cost mainly appraises the fee, court cost and damages for the malpractice or improper malpractice that causes of medical behavior, because hospital image damage and patient run off the income losses led to the fact ' Recessive cost) When.
Adopt the intersection of SPSS13.0 and edition count software, set up to data that collect institute these prevent from the cost in 2006- 2008 years, appraise cost, internal defective cost and external defective cost database, the initial data materials of four kinds of medical quality cost are put in order in unison to three years, calculate three annual mean quality total cost, prevent the cost on average, appraise cost, internal defective cost, external defective cost and proportion in the total cost of average quality of every average unit cost on average on average on average. Based on theory data of the cost of quality, pay rationality to analyze to four kinds of average quality cost of three years of this courtyard, last state and the prevention costs of different year, last cost quality cost when it is different for year and inside or outside last state costs defective, four cost carry on getting related to analyze, count materials adopt 2 test, analyze inside the cost to quality, P<0.05 has statistics meanings.
Until investigation find this institute 2006- 2008 year because medical quality control, main method with measure that control keep stronger consistency, the intersection of prevention and cost its, determine cost, internal defective cost and external defective composition of cost have obvious difference, but because the manpower cost which is engaged in medical quality control rises year by year in three years, every quality accuse of measure strengthen constantly, defective cost different to lead to the fact annual the intersection of quality and cost their store difference in inside or outside the whom some the intersection of quality and defective incident initiate. Contrast the intersection of theory and the intersection of data and model at the same time, this institute average medical the intersection of quality control and cost prevent the cost, determine equally equally promptly the proportion that the cost accounts for is relatively high, all quality cost 79%. Through to preventing the cost, determining every sub cost in the cost is distributed analysis of the state, the medical personnel " Three bases three are tight " With carry out, make a diagnosis regular training and examine expenses regularly and the intersection of case history and the intersection of prescription and spot check, quality the intersection of examination and manpower proportion of cost that cost account for partial and large in the courtyard, and medical quality control education and training, activity cost are relatively slightly low, indicate the medical quality control of this institute is mainly by means of examining, checking and accusing of for the main quality. For this reason, propose setting up dynamic quality cost idea to this institute, launch the intersection of quality and education and train, set up norm make a diagnosis the intersection of workflow and system three quality cost of improve the route in a more cost-effective manner.
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