ABSTRACT
Objective:To analyze the nursing efficiency of clinical departments in general hospitals under the background of medical insurance payment reform, and to explore the methods of rational allocation of resources and improvement of service efficiency.Methods:The relevant data of Qingdao Municipal Hospital from January to December 2020 were selected. The nursing efficiency of 20 clinical departments in the hospital was evaluated by data envelopment analysis (DEA) and Malmquist index. The input indexes were the number of nurses, the number of hours, the number of open beds. The output indicators were number of discharges, average length of stay, and case mix index.Results:In 2020, the average comprehensive efficiency, pure technical efficiency and scale efficiency of 20 clinical departments in the hospital were 0.845, 0.913 and 0.923, respectively.The total factor production efficiency index of the hospital from February to April, from May to September and from October to November were all greater than 1, but the total factor production efficiency index from January to December was less than 1. There were 5 departments with total factor production efficiency index greater than 1.Conclusions:The comprehensive nursing efficiency of clinical departments needs to be improved, and diagnosis related groups (DRG) poses a more severe challenge to the efficiency management of internal medicine nursing. The COVID-19 epidemic has a great impact on the efficiency of nursing services.It is feasible to evaluate the nursing efficiency with DEA model and DRG related indicators.Combined with the disease characteristics and nursing work characteristics of patients admitted to the department, the deep causes should be explored, comprehensive measures should be taken to improve nursing efficiency, precise nursing service transformation based on the reform of medical insurance payment mode should be explored, Internet + nursing service should be promoted, and the improvement of nursing resource efficiency under the status of normal epidemic prevention and control should be paid attention to.
ABSTRACT
Objective To discuss the influence of grading nursing care by physician-nurse cooperation decision-making on the quality of patient care and disease outcomes,and evaluate the application feasibility of nursing core system in this nursing mode.Methods 379 patients were admitted to departments of orthopedics and endocrinology from two hospital areas of our hospital from January 2011 to January 2012.Patients were divided into two groups according to nursing process.Patients who were given conventional grading nursing were set as the routine group,and patients receiving physician-nurse collaboration grading nursing were set as the collaboration group.The nursing quality and nursing efficiency,and the disease outcome of patients were compared between the two groups.Results The quality of care,the qualified rate of care plan implementation,the coverage rate of health education of patients and the patient satisfaction rate were higher in the collaboration group than those in the routine group.The performing rate of doctor's orders,the awareness rate of patient disease,the average length of hospital stay,compliance of medical orders and re-admission rate of patients with the same or a related disease within three months were significantly different between two groups.The collaboration group improved the matching degree of nursing grade with disease condition,understanding of professional knowledge,recording of nursing records,deficient nursing process,and communication ability of life knowledge,compared with those of the routine group.Conchusions Nursing grading mode by physician-nurse collaboration decision-making can obviously improve the defmition of grading nursing and the general treatment effect of patients,it significantly improved the quality of grading nursing.