基于疾病诊断相关组的秩和比法对医院绩效评价  

Comprehensive performance evaluation with RSR statistics method based on disease diagnosis related group

作　　者：万钢[1] 桑雁[1] 郝一炜 李磊[1] 于景祎[1] 马静[1] 王佳静[1] 王中菲 

机构地区：[1]首都医科大学附属北京地坛医院

出　　处：《中国医院统计》2016年第1期19-21,共3页Chinese Journal of Hospital Statistics

摘　　要：目的探讨基于疾病诊断相关组（DRGs）对医疗服务绩效进行秩和比法（RSR）评价。方法利用北京市某三甲医院2015年上半年出院患者的首页信息，通过“北京版诊断相关组（BJ-DRGs）”的病例组合系统分析获取出院患者的DRGs相关信息，运用RSR评价方法对各科室医疗服务进行综合绩效评价。结果1）全院收治疾病大类（MDC）组数为23组，DRGS组数为479组，病例组合指数（CMI）为0．96，接近北京市医疗技术难度的平均水平；费用消耗指数、时间消耗指数分别为1．06、1．07，高于北京市服务效率的平均水平。2）治疗疾病范围最广的是传染科，DRGs组数71个；技术难度最高的为危重症内科部ICU，CMI指数为3．17；泌尿外科的住院时间消耗最短、费用消耗最低；妇产科的住院时间消耗最长、费用消耗最大（1．28，1．46）。3）RSR综合评价显示，最优档为传染科、神经内科、泌尿外科、中西医结合科、ICU；最差档为妇产科、儿科。结论基于DRGs的RSR评价方法，综合了医疗服务广度及难度、医疗服务效率指标，评价结果客观，为医院绩效评价提供了一种可行的方法。Objective To investigate the comprehensive performance evaluation of the hospital with RSR statistics meth- od based the diagnosis related group （DRGs）. Methods The home page information of patients from a hospital in Beijing in the first half of 2015 was analyzed with the use of the Beijing edition of the diagnosis related group （BJ-DRGs）, and then the DRGs related information of patients were obtained. The RSR statistics method was applied to the analysis of comprehensive performance evaluation on the medical services of the departments. Results The hospital treated disease categories （MDC） was 23 groups, DRGs group was 479, and case mix index （CMI） was 0.96, which was close to the average level of medical technology difficulty in Beijing; cost index and time consumption index were 1.06 and 1.07, which were higher than the average level .of the service efficiency. The infectious disease department treated the most diseases, with 71 DRGs groups and the ICU department was with the most difficult treatment, with the case mix index 3.17. The time and pay consumption indexes in nephropathy department were the lowest, while those in obstetrics and gynecology department were 1.28 and 1.46, being the highest. The results of RSR showed the departments with best medical service performance were the department of Infectious diseases, department of Internal Nervous Medicine, department of urology, Chinese and western medicine department and ICU, while ihe departments with worst medical service performance were obstetrics and gynecology department and pediatrics department. Conclusion The RSR evalu- ation method based on the DRGs colligated the width, difficulty and efficiency index of the medical service, the evaluation result was objective, and it provided a feasible method for the hospital medical performance evaluation.

关 键 词：疾病诊断相关组 秩和比法 绩效评价 

分 类 号：R821[医药卫生—临床医学]