基于DRGs死亡风险分级的医疗纠纷分析  

Medical disputes analysis based on DRGs mortality risk ranking

作　　者：庹琳[1] 李萌[1] 王旖旆 胥雪冬[1] 周洪柱[1] Tuo Lin;Li Meng;Wang Yipei;Xu Xuedong;Zhou Hongzhu(Department of Medical Affairs,Peking University Third Hospital,Beijing 100191,China)

机构地区：[1]北京大学第三医院医务处,100191

出　　处：《中华医院管理杂志》2018年第8期648-651,共4页Chinese Journal of Hospital Administration

摘　　要：目的分析2012年至2017年医院整体医疗纠纷案件在DRGs死亡风险分级的不同组别中的情况，以及不同临床科室医疗纠纷在DRGs死亡风险分级的组别情况，从中发现医疗隐患，有的放矢地进行管理干预。方法选取2012年至2017年住院纠纷案例，以北京版疾病诊断相关组（BJ—DRGs）的死亡风险分级不同组别，计算医院医疗纠纷在各组别中的纠纷发生率，并分析内科及外科科室的纠纷发生情况。结果医院的医疗纠纷集中在无死亡病例组和低风险死亡病例组，达到整体纠纷数量的66％；其中外科系统医疗纠纷无死亡病例组和低风险死亡病例组占比更高，达72％，这些病例的CMI值也较低（分别为0．765和1．416）。结论医疗纠纷多发于无死亡病例组和低风险死亡病例组，提示医院在提高医务人员风险意识和落实医疗核心制度方面需要加强管理和培训。Objective To analyze cases in different groups of DRGs mortality risk ranking regarding overall medical dispute cases of the hospital from 2012 to 2017, and to study various groups of such ranking for these disputes as faced by different clinical departments, for the purpose of targeted intervention into medical risk exposures. Methods Inpatient medical dispute cases in 2012 -2017 period were selected, and classified into the various mortality groups by the standards and definition of BJ-DRGs. These data were used to calculate medical dispute incidence in each group, and analyze the difference between internal medicine and surgery departments. ResuLts Medical disputes of the hospital were mostly found in case groups of mortality free and those of low mortality risks, accounting for 66% of the total cases. This figure was the highest in surgical departments, having a percentage as high as 72% , and the CMI values of these cases were low as well （0. 765 and 1. 416 respectively）. Conclusions As case groups of mortality free and low risks tend to attract disputes, the hospital is recommended to enhance the risk awareness and training of its medical staff and key medical regulations.

关 键 词：诊断相关患者组 死亡风险分级 降低风险行为 医疗纠纷 

分 类 号：R197.323[医药卫生—卫生事业管理]