基于疾病诊断相关组(DRGs)的医院绩效TOPSIS评价  

TOPSIS Evaluation of Hospital Performance based on Disease Diagnosis Related Group(DRGs)

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,北京市100015

出　　处：《中国病案》2017年第2期45-48,共4页Chinese Medical Record

摘　　要：目的探讨基于疾病诊断相关组(DRGs)信息对医疗服务绩效优劣解距离法(TOPSIS)评价的应用。方法北京市某三甲医院2015年出院患者的病案首页信息,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TOPSIS评价方法对各科室的医疗服务进行综合绩效评价。结果全院收治疾病大类(MDC)组数为23组,DRGs组数为522组,病例组合指数(CMI)为0.95,接近北京市医疗技术难度的平均水平;费用消耗指数、时间消耗指数指数分别为1.09、1.11,低于北京市服务效率的平均水平。治疗疾病范围最广的是普外科,DRGs组数130个;技术难度最高的为心内科、CCU、神经外科,CMI指数为1.39;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。TOPSIS法综合评价显示,排名前5位的分别为心内科、骨科、普外科、感染二科、肿瘤科;排名后5位的分别为肾内科、产科、妇科、内分泌科、泌尿外科。结论基于DRGs的TOPSIS评价方法,综合了医疗服务广度及难度、医疗服务效率指标,评价的结果客观、可靠,其为医院绩效评价提供了一种合理可行的方法。Objectives To investigate the evaluation of the medical service diagnosis related group （DRGs） in technique for order preference by similarity Methods The front page information of patients from a hospital in Beijing were performance of the hospital based the to an ideal solution statistics method. analyzed by the Beijing edition of the diagnosis related group （BJ-DRGs）, then the DRGS related information of patients were obtained. The TOPSIS statistics method was applied to analyze the medical service performance of hospital. Results The hospital treated disease categories （MDC） was 23 groups, DRGs group was 522, case mix index （CMI） was 0. 95, which was close to the average level of medical technology difficulty in Beijing; cost index, time consumption index were 1.09, 1.11, which were cower than the average level of the service efficiency. The department of most widely used in the treatment of disease was the department of general surgery, the DRGS group was about 130 group, The difficulty of treatment was the department of Cardiology, CCU and department of Neurosurgery, the case mix index was 1.39. The time and pay consumption index of department of urology surgery was the lowest, but the longest was obstetrics and gynecology department. The result of TOPSIS showed the department with best medical service performance were department of cardiology, department of orthopedics, department of general surgery, department of infectious disease, department of oncology, respectively as top 5, the medical service performance of the department of renal medicine, obstetrics, gynecology, of endocrinology, department of urology were lowest respectively. Conclusion The TOPSIS evaluation method based on the DRGs utilized comprehensively the width and difficulty of the medical service, the medical service efficiency index, the evaluation result was objective and reliable, it provided a reasonable and feasible method for the hospital medical performance evaluation.

关 键 词：疾病诊断相关组 TOPSIS 绩效评价 

分 类 号：R197.32[医药卫生—卫生事业管理]