基于病种的精细化医疗管理模式研究与实践  

Research and Practice of the Precise Medical Management Model Based on DRGs

作　　者：郑乐乐[1] 陈善豪[1] 曹卫军[1] 徐鑫[1] 张哲民[1] 

机构地区：[1]上海市肺科医院,上海200433

出　　处：《中国医院管理》2018年第1期33-35,共3页Chinese Hospital Management

基　　金：上海申康医院发展中心市级医院临床管理优化项目(SHDC2014620)

摘　　要：目的以肺部专科疾病为主要研究内容,探索基于病种的精细化医疗管理模式。方法借鉴澳洲版DRGs体系,建立医院病种分类目录,并按病种目录进行绩效评价与考核。结果实施病种管理以来,病例组合指数(CMI)呈明显升高趋势,从2013年0.94提高到2016年的1.04;医疗费用指标基本保持稳定;6个医疗质量指标有明显提高。结论按病种管理有利于优化医院病种结构调整、控制医疗费用以及保证医疗质量。Objective To explore a precise medical management modet based on DRGs, within the special scope of lung diseases. Methods Through taking Australian version of DRGs as an example, the disease catalogue category was established, and performance evaluation was done according to the catalogue. Results After the implement of precise management based on DRGs, CMI increases from 0.94 in 2013 to 1.08 in 2016; the medical expense indicator remains stable; 6 medical service quality indicators have increased dramatically. Conclusion DRGs precise manage- ment based on DRGs helps to optimize the DRGs structure, to control medical expense and to guarantee medical quality.

关 键 词：疾病诊断相关组 病种 医疗管理 

分 类 号：R197.323.2[医药卫生—卫生事业管理]