运用DRGs对综合医院医疗服务绩效的分析  

Analysis on the Medical Service Performance of General Hospital with DRGs

作　　者：李欢 周磊[1] LI Huan;ZHOU Lei(Computer Center of Tongji Hospital,Tongji Medical College,Huazhong University of Science & Technology,Wuhan 430030,Hubei Province,P.R.C)

机构地区：[1]华中科技大学同济医学院附属同济医院计算机中心

出　　处：《中国数字医学》2019年第1期57-60,共4页China Digital Medicine

基　　金：国家高技术研究发展计划(863计划)-医疗信息化体系与信息标准研究(编号:2012AA02A617)~~

摘　　要：目的:通过疾病诊断相关分组(DRGs),从医疗服务能力、医疗服务效率和医疗安全三个维度对综合医院的医疗服务绩效进行评估,并根据评估结果为医院发展提供建议。方法:分析数据来源于湖北省2017病案首页数据库,提取67家三级综合医院一整年的出院病例进行对比分析,引入标化死亡率衡量医疗服务质量。结果:选取数据中,83%的三级综合医院入组率在95%以上;湖北省共覆盖26个MDC,收治MDCY、MDCA类疾病的医疗机构数量最少;67.1%的综合医院出现"缺失专业",41.8%的综合医院出现"低分专业";各医院DRGs组数与CMI指数相距较大;50.7%的综合医院医疗服务效率较高。结论:当前综合医院应重视院内病案首页质控与信息化建设,提升病案首页质量;继续加强学科建设,建立缺失的学科;不断提高医疗安全与质量。Objective: Through Diagnosis Related Groups(DRGs), we assess the service performance of the general hospital by medical service ability, medical service efficiency and medical safety. And then provide recommendations for the development of the hospital according to the results of the assessment. Methods: The analysis data is derived from the medical record home page database of 2017 in Hubei, comparative analysis of one year’s discharge cases from 67 tertiary general hospitals. And introducing the standardized mortality rate to measure the quality of medical service. Results: In the chosen data, 83% of the general hospitals rate of entry is over 95%;Hubei Province covers 26 MDC, and the number of medical institutions in the treatment of MDCY and MDCA diseases is the least;67.1% of the general hospitals have "missing professional";41.8% of the general hospitals have "low professional";the number of DRGs groups and the index of CMI in each hospital have large range;the efficiency of medical service in 50.7% general hospitals is high. Conclusion: At present, the general hospital should pay attention to the quality control and information construction of the medical record home page, and then to improve its quality;continue to strengthen discipline construction and establish missing subjects;Constantly improve medical safety and quality.

关 键 词：疾病诊断相关分组 医疗服务 综合医院 

分 类 号：R197.3[医药卫生—卫生事业管理]