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张美奇, 苏少飞, 王心雨, 蒋皓, 王佳莹, 刘美娜. 基于结直肠癌患者医生治疗质量指标评价[J]. 中国公共卫生, 2017, 33(6): 1014-1017. DOI: 10.11847/zgggws2017-33-06-40
引用本文: 张美奇, 苏少飞, 王心雨, 蒋皓, 王佳莹, 刘美娜. 基于结直肠癌患者医生治疗质量指标评价[J]. 中国公共卫生, 2017, 33(6): 1014-1017. DOI: 10.11847/zgggws2017-33-06-40
ZHANG Mei-qi, SU Shao-fei, WANG Xin-yu.et al, . Assessment of surgeon-based treatment quality of colorectal cancer[J]. Chinese Journal of Public Health, 2017, 33(6): 1014-1017. DOI: 10.11847/zgggws2017-33-06-40
Citation: ZHANG Mei-qi, SU Shao-fei, WANG Xin-yu.et al, . Assessment of surgeon-based treatment quality of colorectal cancer[J]. Chinese Journal of Public Health, 2017, 33(6): 1014-1017. DOI: 10.11847/zgggws2017-33-06-40

基于结直肠癌患者医生治疗质量指标评价

Assessment of surgeon-based treatment quality of colorectal cancer

  • 摘要: 目的 通过单指标使用率及多指标综合得分进行医生结直肠癌治疗质量评价,为结直肠癌治疗质量的改善及医生的绩效考核提供依据。方法 收集哈尔滨市四家医院内出院时间为2011年6月-2013年6月的结直肠癌患者病历信息共1 559份;利用适合使用某评价指标的患者数为分母,适合该指标中实际使用的患者数为分子,计算某评价指标的使用率;利用潜变量模型及贝叶斯参数估计方法,整合多维评价指标,获得医生结直肠癌治疗质量的综合得分。结果 不同医生对评价指标的使用率之间存在较大的差异,术前检查生化指标、肾功能、胸部X线使用率的变异范围为3.9%~97.8%,病理报告中记录检出淋巴结数和阳性淋巴结数使用率的变异范围为95.9%~100.0%;根据潜变量模型计算的综合质量得分,医生的综合质量得分最高为xita12=0.405 7,即该医生的治疗质量最好;其次为xita1=0.3875;最低为xita3=-0.596 7。结论 整合多维评价指标获得综合质量得分,可以多角度全面地对医生治疗质量进行综合评价;计算单指标使用率,可以在综合评价的基础上得到医生对各评价指标的使用情况。

     

    Abstract: Objective To assess surgeon specific treatment quality of colorectal cancer using single indicator usage rate and multi-indicator comprehensive score and to provide evidences for the improvement of treatment quality of colorectal cancer and the performance assessment of doctors.Methods Medical records of 1 159 colorectal cancer inpatients dismissed from 4 hostitals in Harbin city between June 2011 and June 2013 were collected.The surgeon specific treatment item usage rate was calculated by the number of the inpatients with the indication for an examination or treatment being denominated by the number of inpatients receiving the examination or treatment.Latent variable model and Bayesian parameter estimation were adopted to integrate multiple evaluation indicators and then the comprehensive score of treatment quality was calculated for each of the 14 surgeons.Results There were obvious variations in the usage rate of the examination or treatments for the inpatients among the surgeons.The usage rates of preoperative examination of biochemical indicators,renal function,and chest X-ray ranged between 3.9% and 97.8%;the proportion of the surgeons recording the number of lymph nodes detected and the number of lymph node with tumor cell infiltration in pathological report was from 95.9% to 100.0%.The highest surgeon specific comprehensive quality score was 0.405 7 and the second-highest score was 0.387 5;while the lowest score was -0.596 7 for all the surgeons.Conclusion The comprehensive quality score calculated by integrating multi-dimensional indicatiors could be used to evaluate surgeon specific overall treatment quality of colorectal cancer and the usage rate of an examination or treatment could be used to assess indicator specific treatment quality of a surgeon based on the results of comprehensive evaluation.

     

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