因子分析在分析某医院经营机制转变中的应用

目的:探索某医院在经营机制转变中影响医院医疗服务效益的潜在因素,以及这些潜在因素的发展变化.方法:利用"军卫1号"医院信息管理系统采集该院2000～2003年的医疗统计数据,以每个月为观测单位,派生出反映医疗服务效益的8个医疗终末指标:门急诊人次(万人次/月),住院人次(人次/月),手术人次(人次/月),病床使用率(%),病床周转次数次/(床·月)],平均住院日,治愈好转率(%)和住院人均费用(元).运用因子分析方法探索影响医疗服务效益的公因子.然后对观测月份进行有序样品聚类,划分出该院不同发展时期,并进行Kruskal-Wallis H检验比较不同发展时期因子得分的变化.结果:影响医院医疗服务效益有两个潜在因素(公因子):医疗规模-效益因子(F1)和医疗质量-效率因子(F2).在医院发展的初始期、启动期、发展期和稳定期中,前者的因子得分逐渐增大,后者的因子得分没有统计学差异.结论:该医院在转变经营机制的4年中,医疗规模-效益逐步提高,医疗质量-效率保持稳定.不同的公因子在事物发展过程中的变化是不同的.

Application of factor analysis in analyzing management transformation in a Chinese hospital

Objective:To explore the factors influencing the medical service in a Chinese hospital during the period of management transformation,and to study the changes of these factors at different phases of hospital development.Methods: Data were collected from Hospital Information System(HIS) at the end of every month from Jan.2000 to Dec.2003 and 8 variables were deduced: the monthly outpatient visits and emergency visits,the monthly inpatient number,the monthly person-time of operation,bed utilization rate,the monthly cycle of bed rotation,ALS(average length of stay),proportion of cured or recovered patients and expenditure of hospitalization per person.Factor analysis was used to search for the common factors.And Kruskal-Wallis H test was used to compare the mean factor score at different phases divided by ordinal clustering method.Results: There were 2 common factors: quantity-profit factor(F_(1)) and quality-efficiency factor(F_(2)),influencing the medical service in the hospital.F_(1) score increased with the pregression of 4 stages(preliminary,initial,developmental and stable phases) of hospital management transformation and F_(2) score remained unchanged.Conclusion: The quantity-profit of this hospital increases and the quality-efficiency remains unchanged during the 4-year management transformation.Different common factors have different developmental tendency.