应用诊断相关分组进行住院服务评价  

Hospitalization Service Evaluation with the Application of Diagnosis Related Groups

作　　者：李渝[1] 马云波[1] 

机构地区：[1]首都医科大学附属北京安贞医院,北京市100029

出　　处：《中国病案》2016年第8期33-35,共3页Chinese Medical Record

摘　　要：目的通过应用诊断相关分组(diagnosis related groups,DRGs)对医院住院服务进行评价分析,讨论DRGs作为医院绩效指标的优缺点。方法对某三甲综合医院2014年-2015年住院患者DRGs相关的DRG组数、病例组合指数值(case mix index,CMI)、时间消耗指数、费用消耗指数等指标进行比较,从产能、效率、安全等维度进行分析。结果 2015年DRGs相关指标统计结果:DRG组数增加50%,非心血管内外科增加明显;CMI值升高2.26%,心血管外科增高最大为9.57%;时间消耗指数进一步降低7.23%,心血管内科下降11.48%;但费用消耗指数升高明显,为12.96%,MDCF诊断组消耗指数增加24%,考核不达标,进一步控制住院费用成为工作重点。结论 DRGs既可以用来对不同医疗机构提供的服务效率和质量进行比较,也可以对医院本身住院服务进行评价,是较好的医院绩效考核指标,并且可以指导医院的工作重点。但由于DRGs作为评价住院服务存在缺点,所以也应根据实际情况进行合理调整,才能更好地对医院服务进行质量评价。Objectives To conduct evaluation and analysis on the hospitalization service with the application of diagnosis related groups, and discuss the advantages and disadvantages of DRGs as the hospital performance indicators. Methods To make comparison on the indicators included number of DRG sets, CMI, time consumption index, cost consumption index in a Three A and Tertiary Hospital from 2014 to 2015, and conduct analysis from aspects included production capacity, efficiency, safety and other dimensions. Results The statistical results of DRGs indicators in 2015 were：the number of DRG sets increased by 50%,non cardiovascular physician and cardiovascular surgery groups increased significantly;CMI value increased by 2.26%,the largest increase in cardiovascular surgery group was 9.57%;time consumption index decreased by 7.23%,cardiovascular physician group decreased by 11.48%;cost consumption index increased significantly was 12.96%,MDCF diagnostic group consumption index increased by 24%,assessment was not up to standard. The control of hospitalization cost had become the focus of the work. Conclusions DRGs could be used to compare to the service efficiency and quality in different hospitals and also evaluate the inpatients medical service. DRG was the good indicators of hospital performance evaluation, as well as the significant parts of hospital work. But DRGs still existed shortcomings as the evaluation services in hospital, so we should make reasonable adjustments according to the actual situation, thus to be make better quality evaluation on hospital service.

关 键 词：医院住院服务 诊断相关分组 应用 绩效考核指标 DRGS 心血管内外科 住院费用 质量评价 

分 类 号：R197.323[医药卫生—卫生事业管理]