基于RBRVS模型的临床专科能力定量评价实证研究
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摘要
目的探索专科能力定量评价方法的适用性。方法综述分析相关定量方法,并将以资源为基础的相对价值比率用于评价临床诊疗项目技术难度、劳动强度和风险的基础上,通过对每位患者人均使用诊疗项目的RBRVS点数评价难度和风险,以医生年人均点数评价服务强度,以诊疗服务项目种类评价医院的服务广度,作为专科能力量化评价方法。结果实证研究显示:省级医院和市级医院服务能力有显著差异,在通过关键技术项目评价医院服务能力上,定量评价的结果与定性评价相比更为准确。结论关键诊疗技术的RBRVS点数和医生人均手术项目点数,可用于定量评价医院专科能力,并用于指导分级诊疗、住院医师规培、多点执业等。
Objective To explore the applicability of quantitative assessment of specialist ability. Methods Using RBRVS Resource-based Relative Value Scale(RBRVS)to evaluate clinical item technology difficulties,labour intensity and risk.Through using Relative Value Unit(RVU)of patients per capital,evaluating difficulty and risk,evaluating service intensity through doctor RVU per capital,and evaluating hospital service scope through diagnosis and treatment item species to evaluate special ability quantitative evaluation. Results Provincial hospitals' and municipal hospitals' specialist ability show a significant difference using this method. Quantitative assessment is more fitting in term of specialist ability than qualitative assessment. Conclusion RBRVS and RVU can be used for quantitative evaluation of hospital specialist ability to guide hierarchical diagnosis and treatment,resident doctors' training,and multi-sited license,etc.
Objective To explore the applicability of quantitative assessment of specialist ability. Methods Using RBRVS Resource-based Relative Value Scale(RBRVS)to evaluate clinical item technology difficulties,labour intensity and risk.Through using Relative Value Unit(RVU)of patients per capital,evaluating difficulty and risk,evaluating service intensity through doctor RVU per capital,and evaluating hospital service scope through diagnosis and treatment item species to evaluate special ability quantitative evaluation. Results Provincial hospitals' and municipal hospitals' specialist ability show a significant difference using this method. Quantitative assessment is more fitting in term of specialist ability than qualitative assessment. Conclusion RBRVS and RVU can be used for quantitative evaluation of hospital specialist ability to guide hierarchical diagnosis and treatment,resident doctors' training,and multi-sited license,etc.
引文
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[3]FINUCANE P M,BOURGEOIS-LAW G A,INESON S L,et al.Acomparison of performance assessment programs for medical practitioners in Canada,Australia,New Zealand,and the United kingdom[J].Acad Med,2003,78(8):837-843.
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[5]王志刚,牛巍,蔡静,等.RBRVS用于绩效评价的本土化研究与应用[J].中国医院,2015,19(12):4-6.
[2]周绿林,单艾菲,许兴龙.江苏省县级公立医院发展能力及影响因素研究[J].中国医院管理,2018,38(6):32-34.
[3]FINUCANE P M,BOURGEOIS-LAW G A,INESON S L,et al.Acomparison of performance assessment programs for medical practitioners in Canada,Australia,New Zealand,and the United kingdom[J].Acad Med,2003,78(8):837-843.
[4]SHERRY L Smith,SUSAN Clark.Medicare RBRVS 2014:The Physicians Guide[M].Chicago:American Medical Association,2013:26-29.
[5]王志刚,牛巍,蔡静,等.RBRVS用于绩效评价的本土化研究与应用[J].中国医院,2015,19(12):4-6.