DRGs在医院应用中存在的问题与改进建议  

Problems and Improvement Suggestions of DRGs in Hospital Application

作　　者：马黎 钱莎莎 梁世星 楼君唯 张勤[1] 丁丽萍[1] 谭明明[1] MA Li;QIAN Sha-sha;LIANG Shi-xing;LOU Jun-wei;ZHANG Qin;DING Li-ping;TAN Ming-ming(Zhejiang Provincial People's Hospital)

机构地区：[1]浙江省人民医院

出　　处：《医院管理论坛》2019年第9期12-15,共4页Hospital Management Forum

基　　金：2018年医院优秀青年人员科研启动基金,编号:R197.3AZRY2018B010

摘　　要：DRGs在全国各级医疗机构已经得到了广泛的应用,应用过程中也发现了一些问题。针对DRGs分组器不公开的现况,利用病案首页的主要诊断、次要诊断、手术、操作的数据与DRGs入组数据,部署澳大利亚版DRGs分组器或者逆向重构DRGs分组器。针对RW值偏离医院实际诊疗投入的问题,通过选取相关指标,计算DRG组均值与医院均值的相对权重,继而校正该DRG组的RW值。通过明确DRGs分组规则和校正RW值,源头上提升医务人员运用DRGs能力的同时,也让DRGs的结果数据更加客观地体现医疗资源的实际投入,从而进一步提升了DRGs在医院实际应用中的效能。DRGs system has been widely used in medical institutions at all levels in the country.Meanwhile,some problems have been found.To solve the problem of confidentiality of DRGs grouping tool,the method of integrating the main diagnosis,secondary diagnosis,surgery,operation data and DRGs grouping data on the first page of medical records to deploy AR-DRGs grouping tool or reverse reconstruct DRGs grouping tool has been taken.To solve the problem that RW deviates from the actual cost of diagnosis and treatment in hospitals,researches correct the RW value of DRG group by electing relevant indicators to calculating the relative weights of DRG group mean value and hospital mean value.By defining DRGs grouping rules and correcting RW values,the ability of medical staff to use DRGs can be fundamentally improved,while the results/data of DRGs can reflect the actual investment of medical resources more objectively,thus further enhancing the effectiveness of DRGs in the practical application of hospitals.

关 键 词：诊断相关分组 分组器 病案首页 

分 类 号：R197.3[医药卫生—卫生事业管理]