摘要 目的分析我国床位资源优化利用过程中涉及的各主体之间的利益关系,为解决床位资源供求失衡、利用倒置问题提供参考建议。方法利用冲突分析图模型(Graph Model for Conflict Resolution,GMCR)和层次分析法(Analytic Hierarchy Process,AHP),构建GMCR-AHP模型,分析优化床位资源利用过程中有关利益主体之间的矛盾冲突,探讨均衡各方利益的全局稳定状态。结果冲突模型均衡解为YNNYNYYN,即当政府推行分级诊疗并对医院进行政策约束、大医院依靠医联体组织、基层医院积极加入医疗联合体并提高医疗服务质量、患者合理就医时,有利于解决医疗机构床位利用不足和过度利用的极端化问题。结论为缓解床位资源合理利用中的各方利益冲突,政府应该对大医院收治住院患者给予一定的政策约束,各级医院充分发挥联动互助作用,提升整体卫生服务质量,同时积极发展基层医疗卫生服务,提高基层医院公信力。 Objective To analyze the interest relationship between the various subjects involved in the optimal utilization of bed resources in China,and provide reference suggestions for solving the problem of unbalanced supply and demand of bed resources and inversion of utilization.Methods Graph Model for Conflict Resolution(GMCR)and Analytic Hierarchy Process(AHP)were used to construct a GMCR-AHP model to analyze and analyze the conflicts between relevant stakeholders in the process of optimizing the utilization of bed resources,and to explore the overall steady state through balancing benefits of all parties.Results The conflict model is balanced to YNNYNYYN,that is,when the government implements hierarchical diagnosis and treatment and restricts hospital policies,large hospitals rely on the medical alliance,and primary hospitals actively join the medical alliance and improve the quality of medical services.When the patients can see doctors rationally,it is beneficial to solve the insufficient bed utilization of medical institutions,and the extreme problems of overutilization.Conclusion In order to alleviate the conflicts of interests of all parties in the rational use of bed resources,the government should give certain policy constraints to the admission of inpatients in large hospitals.Hospitals at all levels should give full play to the role of linkage and mutual assistance to improve the quality of overall health services,while actively developing primary health care services to improve the credibility of primary hospitals.
机构地区 滨州医学院公共卫生与管理学院
出处 《中国医院管理》 北大核心 2021年第4期38-42,共5页 Chinese Hospital Management
基金 教育部人文社会科学研究青年基金项目(19YJCZH072) 山东省社会科学规划研究项目(19CDNJ01,18CKPJ20) 国家级大学生创新创业训练计划项目(201910440025)。
关键词 资源利用 床位资源 冲突分析图模型 层次分析法 resource utilization bed resources Graph Model for Conflict Resolution Analytic Hierarchy Process
