公立医院与半公立医院手术室设施利用的比较研究

E. K. Wellala, G. Dharmaratne
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引用次数: 0

摘要

手术室(OT)综合体是医院预算支出中昂贵的组成部分。医院活动的这一领域需要最大限度地利用,以确保最佳的成本效益比。对科伦坡地区的两个三级保健中心Sri Jayewardenepura总医院(SJGH)(斯里兰卡唯一的半政府三级保健中心)和科伦坡南教学医院(CSTH)(提供与政府医院类似的服务)进行了研究,以比较利用模式。结果显示,SJGH和CSTH的平均床位利用率差异无统计学意义(P=0.499)。CSTH的平均床位利用率为23.26%,SJGH的平均床位利用率为25.66%。中院与上海综合医院手术室平均床位利用率差异有统计学意义。SJGH的平均每日病床容量利用时间显著高于SJGH (P=0.040)。中港医院的平均床位使用率为11.63%,上海医院则为15.2%。根据顾问对影响利用的因素的重要性的看法,时间管理和有关的行政职能的重要性较低,尽管它们与利用因素的相关性最高。在这两家医院观察到的利用率低于70%至80%的全球基准。这项研究确定了影响利用的因素对人力资源的可得性、动机、培训需要和设备以及资源的可得性的重要性。尽管文献表明时间管理和相关的行政管理因素是最关键的因素,但外科医生对时间管理和相关行政管理功能的重视程度较低。(古普塔,2011)。因此,建议解决“计划手术取消”、“在安排手术室名单时准确预测手术时间”、“方便与其他临床工作安排的手术室时间”、“患者转诊时间”、“患者从病房转移时间”等因素,从而提高手术设施的整体利用率。
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Comparative study on operation theatre facility utilization in government hospitals and semi-government hospitals
The operation theatre (OT) complex is a costly component of a hospital budget expenditure. This area of hospital activity requires maximum utilization to ensure optimum cost-benefit ratio. Two tertiary care centers in the Colombo district, Sri Jayewardenepura General Hospital (SJGH), the only semi-government tertiary care center in Sri Lanka, and Colombo South Teaching Hospital (CSTH) providing similar service delivery to government hospitals were studied to compare utilization patterns. The results showed no significant statistical difference in average per-bed utilization of SJGH and CSTH (P=0.499). The average per-bed utilization rate at CSTH was 23.26%, and SJGH was 25.66%. There was a significant statistical difference in the average per-bed capacity utilization of operating theaters at CSTH and SJGH. The average per bed capacity utilization time per day was significantly higher at SJGH (P=0.040). The average per-bed capacity utilization rate at CSTH was 11.63% and 15.2% at SJGH. According to the Consultants' perception of the importance of factors affecting utilization, less significance is given to time management and related administrative functions even though they have the highest correlation to utilization factors. Utilization observed at both hospitals was lower than the global benchmark between 70% and 80%. The study identified the importance of factors affecting utilization towards human resource availability, motivation, training needs and equipment, and resource availability. Surgeons have given less priority to time management and related administrative functions though the literature suggests time management and relative administratively modifiable factors as the most critical factors. (Gupta, 2011). Therefore, it is recommended to address the factors such as “cancellation of planned surgeries”, “accurate prediction of procedure times in scheduling theatre lists”, “convenient theater time schedules with other clinical work”, “patient turn over time”, and “patient transport time from wards” as they can result in overall improvement in operating facility utilization.
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