探讨DRGs在医院奖励性绩效改革中的应用  

Discussion on the Application of DRGs in the Reward Performance Reform of Hospitals

作　　者：苏臻颖 吴波[1] 薛源[2] 黄鑫[2] 潘娟[2] SU Zhenying;WU Bo;XUE Yuan;HUANG Xin;PAN Juan(Operations Management Office,Fujian Provincial Hospital,Fuzhou Fujian 350001,China;Finance Section,Fujian Provincial Hospital,Fuzhou Fujian 350001,China)

机构地区：[1]福建省立医院经管办,福建福州350001 [2]福建省立医院财务处,福建福州350001

出　　处：《中国卫生标准管理》2019年第21期10-12,共3页China Health Standard Management

基　　金：福建省科技厅软科学项目课题(名称：公立医院内部绩效评价体系应用研究，编号：2018R0028)

摘　　要：目的探讨将疾病诊断相关分类(Diagnosis Related Groups)运用于医院奖励绩效改革中,客观评价临床医疗服务绩效的医院管理新模式。方法采集S医院2016年—2018年病案室数据,对比改革前后,医院相关指标变化,对临床医疗服务绩效评价分析。结果比较2016年、2017年和2018年医院整体情况、单科室、对比分析病例组合指数(the Case Mix Index)、手术例数、三四级手术比例等指标变化情况,说明实行DRGs对医院人员积极性引导与专业技术发展产生的影响。与2016年绩效改革前相比,与2017、2018年DRGs增幅分别为8.87%、15.94%;CMI增幅分别为1.96%、2.94%;手术例数增长分别为8.45%,13.27%;其中三四级手术占手术例数比例从50.89%增长到58.01%,再到65.02%,平均住院日却从原来的11.26日下降到9.81日,再到9.10日。结论将DRGs引用于绩效考核方法,以工作量为主要依据,能够激发员工激励性,加快并规范学科发展,促进医学专业技术发展创新。Objective To explore a new model of hospital management for objective evaluation of clinical medical service performance by applying DRGs to hospital reward performance reform.Methods The data of the case data of S hospital from 2016 to 2018 were collected,and the changes of hospital related indicators were compared before and after the reform,and the performance evaluation of clinical medical services was analyzed.Results The results compared the changes of the hospital's overall situation,single department,comparative analysis of the Case Mix Index(CMI),the number of surgical cases,and the proportion of the third-grade operation in 2016,2017 and 2018,and explained the impact of the implementation of DRGs on the development of medical professional technology.Compared with the performance reform in 2016,the increase in DRGs in 2017 and 2018 were 8.87%and 15.94% respectively.The CMI increase were 1.96% and 2.94% respectively;The number of surgical cases increased by 8.45%,and then by 13.27%;Among them,the proportion of third-grade operations in the number of surgical cases increased from 50.89%to 58.01%,and then to 65.02%.The average hospital day dropped from 11.26 days to 9.81 days,and then to 9.10 days.Conclusion DRGs is introduced into the performance assessment method,and based on the workload,it can stimulate the motivation of employees,accelerate and standardize the development of disciplines,and promote the development and innovation of medical professional technology.

关 键 词：DRGS 绩效奖励 学科发展 工作量 技术创新 积极性 

分 类 号：R197[医药卫生—卫生事业管理]