基于DRGs的医院综合绩效考核指标体系的建立研究  

Establishment of hospital comprehensive performance appraisal index system based on DRGs

作　　者：王玉廷[1] 周小兰[1] 李浩瑞 程康[3] 董霄 刘华[1] 唐双英 张莉[1] 胡浩 WANG Yuting;ZHOU Xiaolan;LI Haorui;CHENG Kang;DONG Xiao;LIU Hua;TANG Shuangying;ZHANG Li;HU Hao(Department of Medical Records Statistics,the Second Affiliated Hospital of Chongqing Medical University,Chongqing 400010,China;School of Medical Information,Chongqing Medical University,Chongqing 400016,China;Department of Economic Management,the Second Affiliated Hospital of Chongqing Medical University,Chongqing 400010,China)

机构地区：[1]重庆医科大学附属第二医院病案统计科,400010 [2]重庆医科大学医学信息学院,400016 [3]重庆医科大学附属第二医院经济管理科,400010

出　　处：《重庆医学》2020年第7期1042-1046,1052,共6页Chongqing medicine

基　　金：重庆市渝中区科学技术委员会科研项目(20180169)。

摘　　要：目的利用德尔菲法、层次分析法(AHP)建立基于疾病诊断相关分类(DRGs)的医院综合绩效考核指标体系。方法通过专家咨询法确定考核指标,再运用AHP建立指标两两对比判断矩阵进行专家问卷调查,将平均分通过归一法确定各级指标权重系数,并进行一致性检验。结果构建了包括4个一级指标、10个二级指标及35个三级指标在内的具有层次性的医院绩效考核指标体系。其中一级指标医疗指标、经济指标、教学科研指标及人事指标权重依次为0.589、0.218、0.122、0.071。三级指标中总权重数、CMI值、病死率、住院抗菌药物使用率、门诊次均费用、低风险死亡率等指标权重较高,组合权重分别为0.078、0.076、0.070、0.058、0.058及0.049。判断矩阵具有一致性(CR=0.098<0.1)。结论结合DRGs构建的医院绩效考核指标体系是合理评价医生工作强度和效率的有效工具,可用于医院人才考核评价,促进医院分配制度进一步改革。Objective To establish the DRGs-based hospital comprehensive performance appraisal index system using Delphi method and Analytic hierarchy process(AHP).Methods Assessment indicators were determined by expert consultation,and then the parewise comparison judgment matrix of indexes was established by AHP for expert questionnaire survey,and the weight coefficients of each index were determined by the average score through normalization method,and the consistency test was carried out.Results The hierarchical hospital performance appraisal index system is constructed,including 4 first-level indexes,10 second-level indexes and 35 third-level indexes.The weight of medical index,economic index,scientific research and teaching index and personnel index was 0.589,0.218,0.122 and 0.071,respectively.The total weight,CMI,case fatality rate,utilization rate of antibiotics in hospital,average outpatient cost per visit,low-risk mortality and other indexes in the third-level indexes have high weight,and the combined weight is 0.078,0.076,0.070,0.058,0.058 and 0.049,respectively.The judgment matrix was consistent(CR=0.098<0.1).Conclusion The hospital performance appraisal index system constructed with DRGs is an effective tool for reasonably evaluating the work intensity and efficiency of doctors,which can be used for evaluation of hospital talents and promote further reform of hospital distribution system.

关 键 词：疾病诊断相关分类 医院绩效 层次分析法 

分 类 号：R195.1[医药卫生—卫生统计学]