医师服务能力画像指标评价体系构建

季斌; 李刚; 郭仁琳; 凌云; 石慧; 李王莺; 赵春艳

doi:10.16766/j.cnki.issn.1674-4152.004312

医师服务能力画像指标评价体系构建

doi: 10.16766/j.cnki.issn.1674-4152.004312

季斌¹,
李刚²,
郭仁琳¹,
凌云¹,
石慧¹,
李王莺¹,
赵春艳^1, ,

1.
上海市东方医院(同济大学附属东方医院)门急诊办公室, 上海 200120
1.
上海市东方医院(同济大学附属东方医院)医疗管理部

基金项目:

上海市卫生健康委员会2025年卫生健康政策研究课题(非定向类) 2025HP75

基于TOC理论的公立医院“一院多区”业务协同发展策略研究 NIHA24YYDQ44

详细信息

通讯作者:
赵春艳，E-mail：53513953@qq.com

中图分类号: R192
计量
- 文章访问数: 7
- HTML全文浏览量: 1
- PDF下载量: 1
- 被引次数: 0
出版历程
- 收稿日期: 2025-07-02
- 网络出版日期: 2026-03-13

Construction of evaluation system for physician service capability portrait indicators

1.
Outpatient and Emergency Office of Shanghai Oriental Hospital(Tongji University Affiliated Oriental Hospital), Shanghai 200120, China

摘要

摘要: 目的探索构建医师服务能力画像指标体系，以科学地评估医师服务质量及能力水平。方法 2025年3—6月研究小组通过系统文献回顾建立初步框架，遴选17名专业领域涉及医院行政管理人员、临床医师、临床护理的专家进行两轮函询，运用层次分析法确定指标权重，通过Kendall W协调系数评价专家共识度。结果两轮问卷有效回收率均为100%，专家权威系数[Cr=0.5×(Ca+Cs)]均为0.87，熟悉度系数达0.85±0.12，判断系数分别为0.89和0.89；第一轮专家协调系数一级指标为0.354、二级指标为0.199、三级指标为0.271，第二轮专家协调系数一级指标为0.292、二级指标为0.211、三级指标为0.266。指标体系最终确立一级指标7个，二级指标26个，三级指标50个。一级指标中，资源画像、流程画像、质量安全画像在整个指标体系中所占权重较大；二级指标中，诊疗环节服务能力、专业技术能力、投诉、纠纷发生情况(防范应对纠纷能力)在整个指标体系中所占权重较大；三级指标中，门诊量、多媒体线上曝光次数、医疗文书书写合格率、纠纷发生率权重显著高于同类指标(P＜0.05)。技术质量维度在整个指标体系中所占权重最大。结论本研究创新性构建了医师服务能力量化评估模型，通过多维特征工程实现对服务能力的精准画像，具有较好的科学性，体系设置合理，能够评价医师服务能力。
- 医师画像 /
- 服务能力 /
- 德尔菲法 /
- 层次分析法
Abstract: Objective To explore the construction of a physician service capability portrait indicator system, with the goal of scientifically evaluating the quality and ability level of physician services. Methods From March to June 2025, the research team established a preliminary framework through a systematic literature review, 17 experts were selected for two rounds of correspondence involving hospital administrators, clinicians, and clinical nursing. to Indicator weights were determined using the Analytic Hierarchy Process, and expert consensus were evaluated using Kendall' s coordination coefficient. Results The effective response rates for both rounds of questionnaires were 100%, with expert authority coefficients [Cr=0.5× (Ca+Cs)] of 0.87, familiarity coefficients of 0.85±0.12, and judgment coefficients of 0.89 and 0.89, respectively. The first round of expert coordination coefficients were 0.354 for the first level indicator, 0.199 for the second level indicator, and 0.271 for the third level indicator. The second round of expert coordination coefficients were 0.292 for the first level indicator, 0.211 for the second level indicator, and 0.266 for the third level indicator. The indicator system ultimately established 7 primary indicators, 26 secondary indicators, and 50 tertiary indicators. Among the first-level indicators, resource portrait, process portrait, and quality and safety portrait accounted for a large weight in the entire index system. Among the secondary indicators, the service ability, professional and technical ability, complaints, and disputes (the ability to prevent and respond to disputes) in the diagnosis and treatment link accounted for a large weight in the entire index system. In the third level indicators, the weight of outpatient volume, multimedia online exposure frequency, medical document writing qualification rate, and dispute occurrence rate were significantly higher than those of similar indicators (P < 0.05). The dimension of technical quality has the highest weight in the entire indicator system. Conclusion This study innovatively constructes a quantitative evaluation model for physician outpatient capabilities, which achieves accurate profiling of service capabilities through multidimensional feature engineering. It has good scientificity, reasonable system settings, and can evaluate physician service capabilities.
- Portrait of a physician /
- Service capabilities /
- Delphi method /
- Analytic hierarchy process

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表 1 17名函询专家基本情况

Table 1. Basic information of 17 correspondence experts

项目	分类	人数(%)
年龄	30~40岁	6(35.29)
	41~50岁	8(47.06)
	＞50岁	3(17.65)
职称	中级职称	10(58.82)
	副高职称	1(5.88)
	正高职称	4(23.53)
	其他	2(11.78)
学历	大学本科	6(35.29)
	硕士研究生	7(41.18)
	博士研究生及以上	4(23.53)
从事本专业的工作年限	＜10年	2(11.76)
	10~19年	8(47.06)
	20~29年	5(29.42)
	≥30年	2(11.76)
岗位类别	行政管理人员	4(23.53)
	临床医师	4(23.53)
	临床护理	9(52.94)

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表 2 两轮指标的协调系数

Table 2. Coordination coefficients of the two rounds of indicators

项目	第一轮			第二轮
项目	一级指标	二级指标	三级指标	一级指标	二级指标	三级指标
专家数量	17	17	17	17	17	17
Kendall's W值	0.354	0.199	0.271	0.292	0.211	0.266
χ²值	36.110	81.067	221.178	29.734	89.786	221.496
df	6	24	48	6	25	49
P值	＜0.001	＜0.001	＜0.001	＜0.001	＜0.001	＜0.001

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表 3 门诊医师服务能力画像指标评价体系

Table 3. Evaluation system of outpatient service ability portrait index

一级指标	二级指标	三级指标	权重	变异系数
资源画像	专业技术能力	普通门诊量	0.154	0.257
		专病门诊年度平均量	0.082	0.316
		专家门诊年度平均量	0.082	0.110
		特需门诊年度平均量	0.080	0.221
		急诊年度平均量	0.081	0.279
		互联网医院门诊年度平均量	0.079	0.243
		互联网医院咨询门诊年度平均量	0.081	0.493
		门诊手术年度平均人次	0.084	0.316
		门诊操作年度平均人次	0.079	0.559
		门诊人次数与出院人次数的比值	0.076	0.191
		外地患者占比	0.073	0.110
		门诊医师开具诊断或医嘱前使用AI或MEDGO次数	0.049	0.154
	语言沟通能力	各类语言证书：如英语、德语、法语、日语等	0.093	0.059
	辐射影响能力	参加义诊次数	0.107	0.257
		院内门诊健康宣教讲座次数	0.143	0.191
		各类公众号健康科普文章/视频：篇数及传播量	0.172	0.154
		下社区健康咨询次数	0.230	0.309
		线上健康指导次数：包括好大夫、抖音、小红书、微信视频号等	0.349	0.191
	多学科协作能力	发启多学科诊疗门诊(MDT门诊)的次数	0.378	0.265
		参加多学科诊疗门诊(MDT门诊)的次数	0.622	0.618
流程画像	预约诊疗服务能力	患者预约率	0.368	0.257
		患者预约后实际就诊率(患者履约率)	0.632	0.059
	候诊环节服务能力	患者候诊时间	1.000	0.154
	诊疗环节服务能力	患者平均就诊时间	0.074	0.316
		未准时出诊次数	0.131	0.265
		无故停诊次数	0.268	0.390
		医疗文书书写合格率	0.526	0.471
服务质量画像	疾病诊治能力	诊断准确率	0.824	0.434
		患者复诊率	0.177	0.221
服务效率画像	接诊能力	接诊密度	1.000	0.154
	团队协作能力	与护理、后勤等职能科室合作沟通情况	1.000	0.110
	投诉、纠纷发生情况	投诉纠纷发生率	0.774	0.191
		投诉、纠纷事件的处理速度	0.226	0.221
	投诉、纠纷处理效率	投诉、纠纷事件的处理结果	1.000	0.221
质量安全画像	精准用药能力	不合理处方数	0.527	0.154
		抗菌药物使用不合理处方数	0.179	0.221
		其他辅助用药不合理处方数	0.294	0.507
	危急值处理能力	30 min内危急值处理及时率	1.000	0.368
	患者满意情况	患者满意度	1.000	0.110
	仪表仪容	有无仪表仪容不规范的情况	1.000	0.059
	医德医风	有无不正当收取礼品、红包、购物卡等贿赂情况	1.000	0.191
	患者表扬	有无收到锦旗或书信的情况	1.000	0.360
	专业职称	对医师的专业技术能力评价，以10分为满分，患者主观打分	1.000	0.375
	收入水平	开放问题	1.000	0.110
	工作满意度	开放问题	1.000	0.265
	同事关系	开放问题	1.000	0.221
	医患关系	开放问题	1.000	0.235
	职称晋升	开放问题	1.000	0.243
	薪酬分配	开放问题	1.000	0.154
	绩效考核	开放问题	1.000	0.265

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