【作者】 赵明钢；

【导师】 张阳德；

【作者基本信息】 中南大学 ， 外科学， 2008， 博士

【摘要】 医疗服务质量是医疗服务组织管理的基础和核心。面对入世以及我国医疗卫生体制改革的推进,提高医疗服务质量已是我国医疗服务组织不断增强患者满意,提高竞争力的有效途径。而建立和完善医疗服务质量管理体系是医疗服务组织提高医疗服务质量的基础和保证。因此,系统研究医疗服务质量的内涵,构建医疗服务质量管理体系的理论框架及体系模式,探索优化医疗服务质量的对策,有其重要的现实意义。2003年国家自然科学基金课题指南提出,对基于人群健康的医学质量指标及评价体系应进行研究,并作为重大课题给予资助。而对医疗服务质量管理体系的研究是上述课题的一个重要组成部分。因此,本论文的研究不仅具有重要的现实指导意义,还具有重要的理论价值。本论文采取理论分析与实证分析、定性分析与定量分析相结合的方法,综合运用质量管理理论、经济学相关理论、顾客满意理论、社会伦理学理论及行为科学理论,在明确本论文研究的目的和意义并分析国内外研究现状的前提下,对医疗服务质量管理体系展开了较为系统的研究。首先,本文在对医疗服务、医疗服务质量进行系统分析的基础上,界定了医疗服务质量的内涵,提出了医疗服务质量目标的内容,包括患者满意度、员工满意度、医技水平等;其次,通过对服务质量特性及质量环的分析,明确了医疗服务的质量特性及质量环,总结了医疗服务质量管理的基本原理,包括质量控制原理、顾客满意原理、效益原理和激励原理;第三,在解析现代质量管理八项原则及医疗服务的公平与效率原则的基础上,探讨了医疗服务质量管理体系的构建目标、特点及模式。文中指出,目前我国医疗服务组织应采用“以过程为基础的质量管理体系模式”;第四,在提出医疗服务质量管理体系绩效评价概念的基础上,构建了医疗服务质量管理体系绩效评价的框架,建立了顾客价值评价、效益价值评价、运作过程价值评价及学习成长价值评价模型;第五,根据本论文上述研究的结论,提出了医疗服务质量优化的五大对策:树立顾客满意经营理念、实施有效质量策划、再造医疗服务流程、建立医疗服务质量信息管理系统、持续改进医疗服务质量;第六,以长沙市中医院为实证分析对象,对其所建立的医疗服务质量管理体系及其运行绩效进行了系统的分析,得出了我国医疗服务组织建立质量管理体系可借鉴的若干经验;最后,对本文的研究结论进行了总结,对未来相关问题的研究进行了展望。更多还原

【Abstract】 The quality of medical treatment service is the foundation and eore of the management of medical treatment service organization.Along with the entering WTO and improvement of the institution reform of medical treatment in our country increasing the quality of medical treatment serviceis a valid way that our country medical treatment service organization can continuously strengthen the customer satisfaction and increase the competitive ability of medical treatment serviee organization. Establishing the system of medical treatment service management and making it perfeet,is the foundation and guarantee of medical treatment service organization improving the quality of medical treatment serviee.Therefore,systematiceal studying the conception of the quality of medical treatment service,setting up the theories frame and mode of system of medical treatment service management,exploring the measure of consummating the quality of medical treatment serviee, have its important realistic meaning.The guide book of National Natural Science Fund Project in 2003 suggest that research on the index sign and evaluation system of medical treatment quality on the foundation of crowd health should be given the pecuniary aid as a very important project. The research of the system of medical treatment service management of medicaltreatmentservice organization is one part of the project which mentioned just now.Therefore,there is notonly important actually guide meaning but also very important theories value on the research of this thesis.This thesis adopts the theories analysis and practical analysis, qualitative analysis and quantitative analysis combining together,and synthesizes making use of the theories of quality management,the related theories of economies, socialethics academic theories and behavioral science theories, under the premise of the establishment of the purpose and meaning of this thesis and the analysis of the domestic and international research present condition,gives a systematical research on the system of medical treatment service quality management.First, this thesis defines the conception of the quality of medical treatment service on the foundation towards systematical analysis on medical treatment service and quality of medical treatment service, suggests the content of target of quality of medical treatment service, including customer satisfaction index,employee satisfaction index and technology level etc;Seeondly, we make the quality characteristic and wreath of medical treatment service clear by the analysis service quality characteristic and wreath,and announce basic principle of the quality of medical treatment service, such as the quality control principle, customer satisfaction principle,value principle and encouragement principle;Thirdly,the thesis studies the establish target,characteristics and mode of the system of medical treatment service quality management on the foundation of the research on the eight principle of modern quality management and equity and efficiency of medical treatment service. It point out that nowadays the medical treatment service organization should adopt the quality management system mode which is on the foundation of process.The fourth, it sets up the value evaluation frame of the medical treatment service quality management system under the premise of suggesting the conception of the value evaluation of medical treatment service quality management system,then establishes the model of customer value evaluation,value evaluation operation process value evaluation and the study and grow value evaluation model; The fifth, according to the conclusion from the above research of this thesis, we suggests the 5 ways to consummate the quality of medical treatment service: set up the customer satisfied operation principle, conduct effective quality planning, arrange the process of medical treatment service, establish the system of the medical treatment service quality information management, continuously improve the medical treatment service quality;The sixth, the thesis systematical analyzes the system of the medical treatment service quality and the operation evaluation, and acquires some useful experiences of establishing the system of medical treatment service organization in our country;In the end, it summarizes the research conclusion of this thesis. and prospects the research on relevant problems in the future.更多还原