Study On Comprehensive Evaluation Index Of Core Medical Quality Of Large Military General Hospital In The New Era

Background:Military hospitals are not only the core medical force to ensure the combat effectiveness of officers and soldiers,but also an important part of the social medical and health system.For military hospitals,medical quality is not only the lifeline,but also the touchstone of combat effectiveness.Since our country launched the new medical reform in 2009,relevant work has been in full swing,and large general hospitals should take the initiative to adapt to the reform and achieve transformation and development.At the same time,the pace of military reform is also accelerating.From the military reform notice issued in March 2016,as of June 2019,reform policies and documents concerning military hospitals have been issued.The development of the army is inseparable from the coordination of logistics,medical and health services,and the development of military hospitals in peacetime also needs to co-ordinate the medical care of the whole people.Therefore,in the new era,the medical quality management of military hospitals is facing new challenges.Research purposes:The purpose of this study is to systematically sort out and present the most cutting-edge literature and information on hospital medical quality,reflecting the characteristics of its current research situation;And to screen and construct evaluation index of core medical quality indicators in large military general hospitals.Through the above research,we hope to further enrich the connotation of medical quality research methods,and to provide a theoretical basis for medical quality management of large military general hospitals in the new era.Method:Firstly,2938 Chinese literatures in the field of medical quality research are taken as the research object,and the visual analysis of medical quality research field is carried out by Cite Space software.On the basis of qualitative and quantitative analysis of the literature,the preliminary core medical quality evaluation index system is determined by the group discussion method,and Delphi is adopted.A total of 35 hospital management experts were consulted and the evaluation indexes of core medical quality in large military general hospitals were screened.Result:Through bibliometric method,the knowledge map of institutional analysis shows that the main body of research is the research department of health administration and the College of health management.The author's knowledge map shows that there is a good cooperative relationship between the main authors in the field.The keyword co-occurrence network map shows the key words of research,and then obtains the medical quality.The research hotspots in quantitative research field are medical safety,hospital management,clinical pathway and comprehensive evaluation.Through Delphi method,seven first-level items(conditions of discipline platform,quality of medical personnel,quality of health readiness,quality of clinical technology innovation,quality of medical technology,quality of medical quality management system,quality of medical service)and 22 secondary items(number of clinical key specialties,rationality of medical equipment configuration,ratio of doctors / nurses to patients,ratio of middle and senior professional titles,quantity and quality of combat readiness equipment,perfection of combat readiness post responsibility system,perfection of combat readiness emergency plan,number of projects,innovation achievements,coincidence rate of clinical and pathological diagnosis,case mix index,case mortality rate of low-risk group,unplanned return to the operating room,reasonable medication rate,medical malpractice recognition rate,hospital infection rate,sound management organization system,management system improvement,average hospital stay,bed utilization rate,implementation rate of soldiers' zero waiting for bed,patient satisfaction)are the core medical quality indicators of large-scale comprehensive military hospital.Conclusion:1.In the past ten years,the research hotspots of medical quality are medical safety,hospital management,clinical pathway and comprehensive evaluation.In the aspect of comprehensive evaluation of medical quality,there are many evaluation models,systems and indicators about medical quality that can be used for reference,but there is still a lack of evaluation index system specifically for the core medical quality of military hospitals in the new era.2.Through Delphi method,we have provided a core medical quality evaluation index system for large military hospitals,which includes 7 first-level items and 22 second-level items,and can be applied to the internal medical quality management of military hospitals.3.In the core medical quality management of the hospital,the conditions of the first level index subject platform,the quality of medical staff allocation,the quality of health readiness,clinical technology innovation,the quality of medical technology,the quality of medical quality management system,and the quality of medical service are relatively close to each other.In the second level index,the number of clinical key specialties,the rationality of medical equipment allocation,the ratio of doctors / nurses to patients,and the middle and senior positions.The most important factors are the ratio,the perfection of the emergency plan,the number of projects,the innovative achievements,the implementation rate of the soldiers' zero waiting for bed and the patients' satisfaction.If the management resources are limited,more attention should be paid to these core indicators.