基于FMEA的临床路径医疗风险成本估计

工业工程 ›› 2012, Vol. 15 ›› Issue (5): 21-25.

基于FMEA的临床路径医疗风险成本估计

仝鹏(1988-)，男，江苏省人，博士研究生，主要研究方向为工业工程和医院管理.

1.天津大学管理与经济学部，天津 300072；2.北京安贞医院，北京 100029

出版日期:2012-10-31 发布日期:2012-11-15
基金资助:
国家自然科学基金资助项目（70871086）

Medical Risk Cost Estimation of Clinical Pathway Based on Failure Mode and Effect Analysis

1. College of Management & Economics，Tianjin University, Tianjin 300072, China；
2. Beijing Anzhen Hospital，Beijing 100029, China

Online:2012-10-31 Published:2012-11-15

摘要/Abstract

摘要： 为了解决目前医疗风险成本研究主要关注医疗风险结果成本，忽视临床路径医疗风险成本估计的问题，提出了一种基于可靠性理论的临床路径医疗风险成本估计的方法。为了验证该方法的性能，以北京市某三级甲等医院食道癌手术临床路径为例，运用事故树分析（FTA）、失效模式与影响分析（FMEA）明确临床路径关键风险因素，并结合临床路径风险频率及严重度评分表与平均风险消除成本，对临床路径医疗风险成本进行量化。计算结果表明：该医院食道癌手术术中加权平均风险消除成本为14 710元，全年食道癌手术术中加权平均医疗风险消除成本为397 290元。所提出方法可以有效地估计临床路径医疗风险成本，并为实际应用提供指导。

关键词: 事故树分析, 失效模式与影响分析, 医疗风险成本

Abstract: Existing studies on medical risk cost mainly pay attention to complication cost, but ignore medical risk cost of clinical pathway. To solve this problem, based on reliability theory, a new inventory method is developed in this paper. By combining fault tree analysis (FTA) with failure mode and effect analysis (FMEA), this method is able to analyze the risk factors in clinical pathway. Then, with average cost of resolve and risk score, the medical risk cost of clinical pathway can be calculated. The performance of the proposed method is evaluated by an esophageal cancer surgery clinical pathway in a hospital in Beijing. It is estimated that the weighted average cost of resolve for an esophageal cancer surgery is 14 710, while the weighted average cost of resolve for an annual esophageal cancer surgery is 397 290, which is a good estimation. Thus, the proposed method can effectively estimate the medical risk cost of a clinical pathway and provides guidance for the practical application.

Key words: fault tree analysis, failure mode and effect analysis, medical risk cost

仝鹏1，刘子先1，倪鑫2，宋青璐1. 基于FMEA的临床路径医疗风险成本估计[J]. 工业工程, 2012, 15(5): 21-25.

Tong Peng1，Liu Zi-xian1， Ni Xin2，Song Qing-lu1. Medical Risk Cost Estimation of Clinical Pathway Based on Failure Mode and Effect Analysis[J]. Industrial Engineering Journal , 2012, 15(5): 21-25.

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