专家评估地区一级口腔颌面服务组织的方法。

M. V. Lebedev, I. M. Son, L. Menshikova, A. V. Gazheva, I.Kh. Tsechoeva
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引用次数: 0

摘要

评估医疗服务的有效性是一项紧迫的任务,因为它可以让我们识别和分析存在的健康潜在风险和组织困难,还可以评估制定预防措施以消除这些风险和困难。目前,还没有一个地区统一的系统来评估地区口腔颌面外科服务现有的组织问题。目的:因此,本研究旨在确定地区口腔颌面外科服务组织的评价标准,并采用专家评估法。材料与方法。我们于2019-2022年采用专家评估法对伏尔加联邦区的基地医疗机构进行了研究。在第一阶段,我们选取了60名口腔颌面外科服务组织的参与者,既有医疗组织层面的,也有地区和联邦层面的。专家们提出了 64 条评价地区口腔颌面外科服务组织的标准,并将其纳入专家评价地图。在第二阶段,我们根据纳入标准选出了 21 位专家,并对提出的标准进行了评分。为了评估问卷结果,我们使用费雪法计算了 95% 的置信区间(MDI)。肯德尔一致系数(W)用于确定专家们对所选标准重要性看法的一致性。如果第一类错误的概率小于 0.05,则认为一致系数的估算是相关的。结果与讨论。通过专家对结果的分析和排序,确定了 20 项最重要的指标,并观察到 8 点以上的指标和 0.7 或以上的一致相关系数。专家们认为,对于组织提供口腔颌面外科服务而言,最重要的问题是是否有规范性文件、患者路由规定、口腔颌面外科服务的提供和基础设施规则、建议的医疗设备标准和建议的人员配备标准、人员配备、提供全天候牙科急诊服务、为颌面部外科手术配备设备和成套手术器械、组织各科室为儿童和残疾人提供口腔颌面外科护理、通过调查定期监测患者满意度。结论确定了评估地区颌面外科服务组织情况的重要标准,从而能够找出活动组织方面的现有缺陷,并概述消除这些缺陷的方法。
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Expert Approaches to Assessing the Organization of Oral and Maxillofacial Service at the regional level.
Evaluating the effectiveness of healthcare services is an urgent task because it allows us to identify and analyze the existence of health potential risks and organizational difficulties, and it also assesses in developing preventive measures to eliminate them. Currently, there is no regional unified system to evaluate the existing organizational issues of the regional oral and maxillofacial surgery service. Purpose: accordingly, this study aims to determine an evaluation criterion for the organization of regional oral and maxillofacial surgery service and use an expert assessments method. Materials and methods. We conducted a study in 2019–2022 on the base medical organizations of the Volga Federal District using an expert evaluation method. In the first phase, we selected 60 participants in the organization of oral and maxillofacial surgery service, both at the level of the medical organization and at the regional and federal levels. The experts proposed 64 criteria for evaluating the organization of regional oral and maxillofacial services, which were included in the map of expert evaluation. In the second phase, we selected 21 experts by the inclusion criteria and scored the proposed criteria. To evaluate the questionnaire results, 95 percent of the confidence interval (MDI) was calculated using Fisher’s method. Kendall’s coefficient of concordance (W) was used to determine the consistency of experts’ views on the importance of the criteria chosen. The estimation of the concordance coefficient was considered relevant if the probability of the first type of error was less than 0.05. Results and discussion. Analysis of the results and their ranking by experts made it possible to identify the 20 most significant indicators and observe more than 8 points and a concordance correlation coefficient of 0.7 or more. According to experts, for organizing the provision of oral and maxillofacial surgery service, the most important issue is the availability of regulatory documents, regulations for routing patients, rules for the provision and infrastructure of oral and maxillofacial surgery service, the recommended standard of medical equipment and recommended staffing standards, staffing, the availability of emergency round-the-clock dental service, equipping a panel of devices, sets of surgical instruments for surgical interventions in the maxillofacial region, organizing the provision of care in oral and maxillofacial surgery for children and the disabled in the departments, regular monitoring of patient satisfaction by surveys. Conclusions. Significant criteria for assessing the organization of regional maxillofacial surgical service were identified, which made it possible to identify existing shortcomings in the organization of activities and outline ways to eliminate them.
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