2023-2025年上海市三级公立医院运行状况分析OA
Analysis on the current status of tertiary public hospitals in Shanghai from 2023 to 2025
目的 重点分析2023-2025年上海市三级公立医院分级诊疗体系建设、临床诊疗能力、医疗质量安全、合理用药、医疗服务效率、信息化支撑、人员结构、患者满意度、医务人员满意度等方面的情况,并比较综合医院与非综合医院的运行状况,为公立医院的精细化管理和高质量发展提供参考.方法 选择上海市57家三级公立医院作为研究对象,参考《2023年度全国三级公立医院绩效监测分析情况通报》选取研究指标,选取2023-2025年上海市医疗服务监测与评价系统的相关数据,采用柱状图和雷达图直观展示上海市三级公立医院的运行状况及其变化.结果 上海市三级公立医院呈现总体向好的发展趋势,出院患者手术占比稳定在39.40%左右,出院患者微创手术占比从24.79%上升至26.55%,DRGs低风险组死亡率从0.68‰下降至0.33‰,卫生技术人员和护士分别增长0.60万人和0.39万人.综合医院和非综合医院总体表现各有所长,2023-2025年综合医院的出院患者四级手术占比稳定在24.50%左右,非综合医院为20.70%～24.42%;2023-2024年综合医院的医疗服务收入占比下降0.73%,非综合医院下降7.82%,波动性较大.2023年综合医院抗菌药物使用强度为43.50 DDDs,高于非综合医院的34.86 DDDs.结论 上海市三级公立医院运行状况整体较好,建议未来关注医疗总收入增长与检查收入增长的平衡,优化门诊预约诊疗制度,改善医院的就医环境,关注抗菌药物的使用,进一步促进上海市三级公立医院高质量发展.
Objective This study aims to analyze the status of tertiary public hospitals in Shanghai from 2023 to 2025 across multiple dimensions,including construction of hierarchical diagnosis and treatment system,clinical diagnosis and treatment ability,medical quality and safety,rational medication use,medical service efficiency,information support,workforce structure,patient satisfaction,and medical staff satisfaction,and to compare the operation status of general hospitals and specialist hospitals,providing reference for the precision management and high-quality development of public hospitals.Methods A total of 57 tertiary public hospitals in Shanghai were included.Research indicators were selected with reference to the 2023 National Tertiary Public Hospital Performance Monitoring and Analysis Bulletin.Data of the Shanghai Healthcare Service Monitoring and Evaluation System(SHVMS)from 2023 to 2025 were extracted,bar charts and radar charts were used to visualize the operational status and trends of tertiary public hospitals in Shanghai.Results Tertiary public hospitals in Shanghai showed an overall positive development trend.The proportion of discharged patients undergoing surgery remained stable at approximately 39.40%;the proportion undergoing minimally invasive surgery increased from 24.79%to 26.55%;the mortality rate in the DRG low-risk group declined from 0.68‰ to 0.33‰;and the numbers of healthcare technicians and nurses increased by 6,000 and 3,900,respectively.General hospitals and specialist hospitals each demonstrated distinct strengths overall.The proportion of discharged patients undergoing grade IV surgery in general hospitals remained stable at approximately 24.50%over the study period,while the corresponding proportion in specialist hospitals ranged from 20.70%to 24.42%.The proportion of medical service revenue in total income decreased by 0.73%in general hospitals and by 7.82%in specialist hospitals from 2023 to 2024,with considerable fluctuation observed in both.The use intensity of antibiotics in general hospitals was 43.50 DDDs in 2023,higher than that in specialist hospitals(34.86 DDDs).Conclusions Tertiary public hospitals in Shanghai demonstrated an overall satisfactory operational status.This study recommends that future efforts focus on balancing the growth of total medical revenue with examination-related revenue,optimizing the outpatient appointment system,improving the hospital care environment,and promoting rational antimicrobial use,so as to further advance the high-quality development of tertiary public hospitals in Shanghai.
施骏;信虹云;张蕴伟
上海市卫生和健康发展研究中心(上海市医学科学技术情报研究所),上海 200031上海市卫生和健康发展研究中心(上海市医学科学技术情报研究所),上海 200031上海市卫生和健康发展研究中心(上海市医学科学技术情报研究所),上海 200031
医药卫生
三级公立医院绩效考核现状分析发展建议
tertiary public hospitalsperformance appraisalstatus analysisdevelopment suggestions
《健康发展与政策研究》 2026 (2)
209-215,7
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