目的：在医用耗材管理改革和医院精细化管理背景下，越来越多的医疗机构开始探索使用供应-拆分加工-配送（SPD）模式用以管理医用耗材，SPD供应链服务平台的渗透率不断提升。但是，由于中国SPD模式发展时间尚短，SPD服务平台与医疗机构合作模式多样，运用、管理与评价没有统一标准化的指标。因此，本研究拟构建一套科学可靠的医用耗材SPD服务平台评价指标体系，为医院评价和选择已运行的医用耗材SPD服务平台提供参考，提出未来改进建议。方法：首先基于服务质量模型（SERVQUAL）和供应链运营参考模型（SCOR），结合文献研究、专家访谈与医院需求，初步搭建了针对SPD服务平台的评价指标体系；然后采取德尔菲法邀请专家对指标进行讨论和筛选，确定最终的指标体系后，通过层次分析法确定各指标具体的权重；最后，纳入5家医院合作的SPD服务平台进行实证研究，利用VIKOR法对评价结果进行分析。结果：最终评价指标体系包括了“医院：主观评价”和“平台绩效：客观数据”两个一级指标，下设有可靠性、响应性、保证性、移情性、服务质量、响应速度、成本、内部管理八个二级指标和三十个三级指标。在一级指标中，“医院：主观评价”权重大于“平台绩效：客观数据”，二级指标按权重大小排序依次为可靠性、服务质量、保证性、响应性、响应速度、移情性、内部管理、成本。实证结果显示，各案例SPD服务平台评价排序为S2、S3、S1、S4、S5，各自需要重点改善的二级指标分别为响应速度、可靠性、移情性、响应速度、响应性。结论：本研究从医院主观评价和平台客观数据维度搭建了可用于评价、监督和改进SPD服务平台的三级评价指标体系，最终评价体系较为关注SPD服务平台配送医用耗材等核心工作能力。并且，该评价指标体系系统全面，相关实证研究表明其具有一定可操作性和适宜性，可用于评价、监督和改进SPD服务平台。最终，研究建议医院应与SPD服务平台权责明确，边界界定清晰，加强对SPD服务平台的风险控制，同时搭建和持续性改进SPD服务平台评价指标体系；SPD服务平台则需要强化自身的核心工作能力，探索多元化服务形式，提高耗材精细化管理能力，最终帮助医院实现降本增效。
Objective: Under the background of the management reform of medical consumables and the refined management of hospitals, more and more hospitals have begun to explore a way to manage medical consumables with Supply-Processing-Distribution mode, and the penetration rate of the SPD supply chain service platform has been increasing. However, the SPD mode development is still a new thing in China, and there are diverse cooperation modes between the SPD service platform and medical organizations. There is no united and standardized index for management and evaluation. Thus, this study plans to build up a set of scientific and reliable index evaluation systems for the SPD service platforms of medical consumables to provide a reference for the hospitals to evaluate and select the SPD service platforms of medical consumables and raises some suggestions for improvement.Methods: Firstly, based on the SERVQUA model and SCOR model, combined with the literature study, experts interview and the demands of hospitals, the study initially builds up the indexes evaluation system for SPD service platforms. Then, it is adopted with the Delphi method to invite the experts to discuss and screen the indexes to confirm the final indexes system. Later, using the analytic hierarchy process to determine the weight of all specific indexes. Finally, there is an empirical study on the SPD service platforms of 5 case hospitals, and the evaluation results are analyzed with the VIKOR method.Results: The final evaluation indexes system includes the two grade-one indexes: “hospital: objective evaluation” and “platform performance: objective data”, and it is set with eight grade-two indexes and thirty grade-three indexes, including reliability, responsiveness, assurance, empathy, service quality, response speed, cost and internal management. In the grade-one index, the weight of “hospital: objective evaluation” is higher than that of the “platform performance: objective data”. According to the sorting of weight of the grade-two indexes, they are ranked to be reliability, service quality, assurance, responsiveness, response speed, empathy, internal management and cost.Conclusion: This study builds up a three-level evaluation indexes system that could evaluate and improve the SPD service platforms with the dimensions of the subjective evaluation of hospitals and the objective data of platforms. The ultimate evaluation system would pay more attention to the core work capabilities of the SPD service platform, such as the distribution of medical consumables. And, the evaluation index system is comprehensive. In addition, the empirical results show that this evaluation system has certain operability and suitability, and can be used to evaluate, supervise, and improve the SPD service platform. The study suggests that hospitals should clarify the rights and responsibilities of the SPD service platform, have a clear boundary definition, enhance the risk control of the SPD service platform and build up the indexes evaluation system for the SPD service platform with continuous improvement; the SPD service platforms need to enhance their core work capabilities and explore a form of diverse services to improve the refined management capability of the consumables so as to help hospitals achieve the cost reduction and profit increase in the end.
