Practice and development of day surgery for municipal third-level public hospital under guidance of national hospital performance appraisal system_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

YANG Yuan ^1,2,3 ,  YU Deshui ^4,5 ,  CHEN Xinzu ^1,2,6,7

1. Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;
2. Gastric Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;
3. Department of Gastrointestinal and Hernia Surgery, Yibin Second People’s Hospital (West China Yibin Hospital, Sichuan University), Yibin, Sichuan 644000, P. R. China;
4. Department of Medical Administration, Yibin Second People’s Hospital (West China Yibin Hospital, Sichuan University), Yibin, Sichuan 644000, P. R. China;
5. Department of Day Surgery, Yibin Second People’s Hospital (West China Yibin Hospital, Sichuan University), Yibin, Sichuan 644000, P. R. China;
6. Yibin Cancer Prevention and Control Center, Yibin Second People’s Hospital (West China Yibin Hospital, Sichuan University), Yibin, Sichuan 644000, P. R. China;
7. Ya’an Cancer Prevention and Control Center, Ya’an People’s Hospital (West China Ya’an Hospital, Sichuan University), Ya’an, Sichuan 625000, P. R. China;

Corresponding author：

YU Deshui, Email: yds2007110312@sina.com; CHEN Xinzu, Email: chenxinzu@scu.edu.cn

Keywords：

day surgery; public hospital; high-quality development; national hospital performance appraisal system; medical quality

DOI：

10.7507/1007-9424.202312055

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Objective To analyze the efficacy of promoting the development of day surgery in a municipal third-level public hospital under the guidance of national hospital performance appraisal system. Method The annual data relevant day surgery in the Yibin Second People’s Hospital were collected from 2016 to 2022, which were divided into three stages: 2016–2018, 2019–2020, and 2021–2022. The trend and correlation of the performance appraisal indicators were analyzed. Results The day surgery in the Yibin Second People’s Hospital started in 2018, and its proportion in the elective surgery was only 1.2% in 2018, then increased continuously after the implementation of performance appraisal system, and was up to 34.7% in 2022. From 2016 to 2022, the proportion of discharged patients underwent surgery in the entire hospital increased continuously from 22.4% in 2016 to 35.7% in 2022, and the average hospital stay in the entire hospital gradually decreased from 10.9 d to 8.1 d, which both had a significant linear correlation with the proportion of day surgery in the elective surgery (r_s=0.93, P=0.002; r_s=–0.99, P<0.001, respectively). In the recent implementation of performance appraisal system, the re-operation rate after day surgery was less than 0.1%, the readmission rate of day surgery after discharge was 0%, and the satisfaction rate of day surgery patients was more than 95.0%, which reached 97.0% by 2022, higher than the average level of inpatient satisfaction in the entire hospital. Taking laparoscopic cholecystectomy, cataract phacoemulsification and intraocular lens implantation, internal fixation extraction, vocal cord polypectomy, and endoscopic gastric polypectomy as example, the average total hospitalization cost and average cost excluding drug and medical materials consumption of the day surgery all decreased compared to non-day-surgery mode, respectively. Conclusion Under the guidance of national hospital performance appraisal system, day surgery has entered a rapid developing stage, but it is still necessary to promote the medical quality by standardized, precise, and informationized day surgery management.

Citation： YANG Yuan, YU Deshui, CHEN Xinzu. Practice and development of day surgery for municipal third-level public hospital under guidance of national hospital performance appraisal system. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2024, 31(5): 593-599. doi: 10.7507/1007-9424.202312055 Copy

1.	刘庭芳. 公立医院绩效考核: 用一根尺子测量全国. 中国卫生, 2021, (4): 28-29.
2.	徐书贤. 新形势下, 公立医院如何走好绩效考核发展之路. 中国医院院长, 2020, 16(23): 34-37.
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6.	国家卫生健康委办公厅. 《国家三级公立医院绩效考核操作手册(2019版)》(国卫办医函〔2019〕492号). URL: http://www.nhc.gov.cn/yzygj/s3593g/201905/63feeb5dae7c4125a06d31f3600c0bc8.shtml.
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8.	国家卫生健康委办公厅. 《国家三级公立医院绩效考核操作手册(2023版)》(国卫办医政函〔2023〕49号). URL: http://www.nhc.gov.cn/yzygj/s3594q/202302/66bc281991da43c4a0e85eba4829530a.shtml.
9.	李关平, 谭永琼, 黄文霞. 日间手术模式的实践及经验. 华西医学, 2011, 26(10): 1568-1570.
10.	蒋丽莎, 马洪升. 日间手术评价与监控指标初探. 华西医学, 2019, 34(2): 202-205.
11.	陈相军, 宋应寒, 陈敏, 等. 四川大学华西医院日间手术质量和安全管理规范. 华西医学, 2019, 34(2): 155-158.
12.	马洪升. 日间手术的管理. 华西医学, 2017, 32(4): 481-482.
13.	马洪升. 日间手术: 一种富有挑战性的手术管理模式. 华西医学, 2019, 34(2): 113-115.
14.	苑伟, 雷甜甜, 文茂瑶, 等. 四川大学华西医院日间手术患者管理模式初探. 华西医学, 2019, 34(2): 188-192.
15.	蒋丽莎, 谢晓兰, 戴燕, 等. 四川大学华西医院日间手术入院前管理规范. 华西医学, 2019, 34(2): 133-136.
16.	国家卫生健康委办公厅. 《日间手术推荐目录(2022年版)》(国卫办医函〔2022〕38号). URL: http://www.nhc.gov.cn/yzygj/s3594q/202202/f57ca70b23f34ca88308979ef19bde4b.shtml.
17.	国家卫生健康委办公厅. 《医疗机构日间医疗质量管理暂行规定》(国卫办医政发〔2022〕16号). URL: http://www.nhc.gov.cn/yzygj/pqt/202211/8c13f9111fde4c94bcc5542cf83fd7c1.shtml.
18.	蒋丽莎, 孙佳璐, 杨建超, 等. 基于结构-过程-结果理论的日间手术质量与安全评价指标体系方法研究. 华西医学, 2022, 37(4): 581-585.
19.	国家卫生计生委办公厅, 人力资源社会保障部办公厅. 《关于印发日间手术试点医院名单的通知》(国卫办医函〔2017〕1100号). URL: http://www.nhc.gov.cn/yzygj/s3594q/201806/41dfe7766a3e4c31976134eee08eb1a8.shtml.
20.	国家卫生计生委, 国家中医药局. 《关于印发进一步改善医疗服务行动计划的通知》(国卫医发〔2015〕2号). URL: http://www.nhc.gov.cn/yzygj/s3593g/201501/5584853cfa254d1aa4e38de0700891fa.shtml.
21.	中国日间手术合作联盟. 关于中国日间手术合作联盟的简介. URL:http://www.chinaasa.org/col.jsp?id=111.
22.	中华人民共和国国家卫生和计划生育委员会. 2016年深入落实进一步改善医疗服务行动计划重点工作方案. 中国实用乡村医生杂志, 2016, 23(6): 18-20.
23.	喻昆霖. 地市级医院开展日间手术模式的应用与效果评价. 当代医学, 2022, 28(5): 138-140.
24.	国务院办公厅. 《关于加强三级公立医院绩效考核工作的意见》(国办发〔2019〕4号). URL: http://www.nhc.gov.cn/yzygj/s7653/201901/5da6e59268b04e659574e3006c3b6615.shtml.
25.	周宏珍, 吴韫宏, 滕燕飞, 等. 日间手术管理对医疗费用及其结构影响的中断时间序列分析. 中国卫生信息管理杂志, 2023, 20(4): 658-665.
26.	Glowka L, Tanella A, Hyman JB. Quality indicators and outcomes in ambulatory surgery. Curr Opin Anaesthesiol, 2023, 36(6): 624-629.Glowka L, Tanella A, Hyman JB. Quality indicators and outcomes in ambulatory surgery. Curr Opin Anaesthesiol, 2023, 36(6): 624-629.
27.	张燕萍. 以临床需求为导向的日间手术信息管理系统设计与效果分析. 医院管理论坛, 2022, 39(3): 94-96.
28.	王迎娣, 钱敏, 郑军, 等. 基于信息化赋能的日间手术全周期服务体系构建与实践. 江苏卫生事业管理, 2023, 34(7): 941-944.
29.	孙辉, 王凯, 朱宏, 等. 2016–2022年我国日间手术术式变化及对日间手术规范化发展的思考. 中国医院, 2022, 26(8): 10-13.
30.	董魁, 王亚宁, 孙斌. 三级公立医院绩效考核对日间手术发展的影响及改进策略研究. 现代医院管理, 2022, 20(30): 29-32.

1. 刘庭芳. 公立医院绩效考核: 用一根尺子测量全国. 中国卫生, 2021, (4): 28-29.
2. 徐书贤. 新形势下, 公立医院如何走好绩效考核发展之路. 中国医院院长, 2020, 16(23): 34-37.
3. 国家卫生健康委办公厅, 国家中医药管理局办公室. 《公立医院高质量发展评价指标(试行)》(国卫办医发〔2022〕9号). URL:http://www.nhc.gov.cn/yzygj/s3594q/202207/3324136282364655baa64f6e84fe0792.shtml.
4. 国家卫生计生委办公厅, 国家中医药局办公室. 《<进一步改善医疗服务行动计划>实施方案(2015–2017年)》(国卫办医发〔2015〕33号). URL: http://www.nhc.gov.cn/yzygj/s3593g/201506/cbe5494282d24e97a001e81e0325e1b1.shtml.
5. 俞德梁, 刘小南. 我国日间手术政策文件的可视化分析. 中国卫生质量管理, 2022, 29(10): 31-34.
6. 国家卫生健康委办公厅. 《国家三级公立医院绩效考核操作手册(2019版)》(国卫办医函〔2019〕492号). URL: http://www.nhc.gov.cn/yzygj/s3593g/201905/63feeb5dae7c4125a06d31f3600c0bc8.shtml.
7. 国家卫生健康委办公厅. 《国家三级公立医院绩效考核操作手册(2022版)》(国卫办医函〔2022〕92号). URL: http://www.nhc.gov.cn/yzygj/ylyxjg/202204/d61b7201a56643d1a876e103340e5897.shtml.
8. 国家卫生健康委办公厅. 《国家三级公立医院绩效考核操作手册(2023版)》(国卫办医政函〔2023〕49号). URL: http://www.nhc.gov.cn/yzygj/s3594q/202302/66bc281991da43c4a0e85eba4829530a.shtml.
9. 李关平, 谭永琼, 黄文霞. 日间手术模式的实践及经验. 华西医学, 2011, 26(10): 1568-1570.
10. 蒋丽莎, 马洪升. 日间手术评价与监控指标初探. 华西医学, 2019, 34(2): 202-205.
11. 陈相军, 宋应寒, 陈敏, 等. 四川大学华西医院日间手术质量和安全管理规范. 华西医学, 2019, 34(2): 155-158.
12. 马洪升. 日间手术的管理. 华西医学, 2017, 32(4): 481-482.
13. 马洪升. 日间手术: 一种富有挑战性的手术管理模式. 华西医学, 2019, 34(2): 113-115.
14. 苑伟, 雷甜甜, 文茂瑶, 等. 四川大学华西医院日间手术患者管理模式初探. 华西医学, 2019, 34(2): 188-192.
15. 蒋丽莎, 谢晓兰, 戴燕, 等. 四川大学华西医院日间手术入院前管理规范. 华西医学, 2019, 34(2): 133-136.
16. 国家卫生健康委办公厅. 《日间手术推荐目录(2022年版)》(国卫办医函〔2022〕38号). URL: http://www.nhc.gov.cn/yzygj/s3594q/202202/f57ca70b23f34ca88308979ef19bde4b.shtml.
17. 国家卫生健康委办公厅. 《医疗机构日间医疗质量管理暂行规定》(国卫办医政发〔2022〕16号). URL: http://www.nhc.gov.cn/yzygj/pqt/202211/8c13f9111fde4c94bcc5542cf83fd7c1.shtml.
18. 蒋丽莎, 孙佳璐, 杨建超, 等. 基于结构-过程-结果理论的日间手术质量与安全评价指标体系方法研究. 华西医学, 2022, 37(4): 581-585.
19. 国家卫生计生委办公厅, 人力资源社会保障部办公厅. 《关于印发日间手术试点医院名单的通知》(国卫办医函〔2017〕1100号). URL: http://www.nhc.gov.cn/yzygj/s3594q/201806/41dfe7766a3e4c31976134eee08eb1a8.shtml.
20. 国家卫生计生委, 国家中医药局. 《关于印发进一步改善医疗服务行动计划的通知》(国卫医发〔2015〕2号). URL: http://www.nhc.gov.cn/yzygj/s3593g/201501/5584853cfa254d1aa4e38de0700891fa.shtml.
21. 中国日间手术合作联盟. 关于中国日间手术合作联盟的简介. URL:http://www.chinaasa.org/col.jsp?id=111.
22. 中华人民共和国国家卫生和计划生育委员会. 2016年深入落实进一步改善医疗服务行动计划重点工作方案. 中国实用乡村医生杂志, 2016, 23(6): 18-20.
23. 喻昆霖. 地市级医院开展日间手术模式的应用与效果评价. 当代医学, 2022, 28(5): 138-140.
24. 国务院办公厅. 《关于加强三级公立医院绩效考核工作的意见》(国办发〔2019〕4号). URL: http://www.nhc.gov.cn/yzygj/s7653/201901/5da6e59268b04e659574e3006c3b6615.shtml.
25. 周宏珍, 吴韫宏, 滕燕飞, 等. 日间手术管理对医疗费用及其结构影响的中断时间序列分析. 中国卫生信息管理杂志, 2023, 20(4): 658-665.
26. Glowka L, Tanella A, Hyman JB. Quality indicators and outcomes in ambulatory surgery. Curr Opin Anaesthesiol, 2023, 36(6): 624-629.Glowka L, Tanella A, Hyman JB. Quality indicators and outcomes in ambulatory surgery. Curr Opin Anaesthesiol, 2023, 36(6): 624-629.
27. 张燕萍. 以临床需求为导向的日间手术信息管理系统设计与效果分析. 医院管理论坛, 2022, 39(3): 94-96.
28. 王迎娣, 钱敏, 郑军, 等. 基于信息化赋能的日间手术全周期服务体系构建与实践. 江苏卫生事业管理, 2023, 34(7): 941-944.
29. 孙辉, 王凯, 朱宏, 等. 2016–2022年我国日间手术术式变化及对日间手术规范化发展的思考. 中国医院, 2022, 26(8): 10-13.
30. 董魁, 王亚宁, 孙斌. 三级公立医院绩效考核对日间手术发展的影响及改进策略研究. 现代医院管理, 2022, 20(30): 29-32.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Practice and development of day surgery for municipal third-level public hospital under guidance of national hospital performance appraisal system

Abstract Full text Figures/Tables Video References Cited by

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