基于医院DRG绩效管理的“离标差之和”方法研究  

Research on the"Sum of Deviation from Standard"method based on hospital DRG performance management

作　　者：郑盼 郭佳奕[1] 袁坚列[1] 杜金林[1] 俞世安[1] 陈海君[1] 徐敏慧[1] ZHENG Pan;GUO Jiayi;YUAN Jianlie;DU Jinlin;YU Shian;CHEN Haijun;XU Minhui(Jinhua Municipal Central Hospital,No.365,Renmin East Road,Wucheng District,Jinhua,321000,Zhejiang Province,PRC)

机构地区：[1]金华市中心医院,浙江省金华市321000

出　　处：《中国医院》2020年第5期16-18,共3页Chinese Hospitals

基　　金：浙江省医药卫生科技计划项目(2020KY1011);金华市科技局项目(2019-4-001)。

摘　　要：目的:研究病例组合指数(CMI)在医院及科室层面的变化因素,应用CMI值对大型医院科室病种结构进行评价,探索病种结构优化方案。方法:基于浙江省DRG平台数据,采集2018-2019年住院患者信息;主要指标为CMI及DRG组,探索采用"离标差之和"及"离标差之和"的差值,分析医院及科室病种结构变化。结果:(1)各RW级别出院患者均增多;(2)不同RW级别增幅不同,RW<0.5组的增幅高于其他组,差异有统计学意义;(3)2019年上半年,"离标差之和"负值最大的MDC是MDCR组,负值最大的科室是眼科;(4)"离标差之和"差值最大的MDC是MDCR组,负值最大的科室是眼科,负值最大的DRG组是"GM10Z"组。结论:通过建立"离标差之和"及"离标差之和"差值变化能快速精准定位医院及科室的病种收治变化,为进一步深入分析及改进提供有力依据。Objective:To study the variability of the case mix index(CMI)at the hospital and departmental level,to evaluate the disease structure of large hospital departments by applying CMI values,and to explore the optimization scheme of disease structure.Methods:Based on the data of DRG platform in Zhejiang Province,information on inpatients in 2018-2019 was collected;the main indicators were CMI and DRG group,and the differences of"sum of deviations"and"sum of deviations"were used to analyze the changes in the structure of hospital and departmental diseases.Results:(1)The number of patients discharged from hospitals increased for all RW levels;(2)the increase was different for different RW levels,the increase in RW<0.5 group was higher than other groups,the difference was statistically significant;(3)in the first half of 2019,the MDC with the largest negative value of"sum of deviation"was the MDCR group,the largest negative value of the department was ophthalmology;(4)the MDC with the largest difference of"sum of deviation"was the MDCR group,the largest negative value of the department was ophthalmology,the largest negative value of the DRG group was"GM10 Z"group.Conclusion:The establishment of"sum of deviations"and"sum of deviations"can quickly and accurately locate the changes in hospital and departmental admissions and provide a strong basis for further in-depth analysis and improvement.

关 键 词：疾病诊断相关分组 病例组合指数 绩效管理 

分 类 号：R197[医药卫生—卫生事业管理]