DRGs在三级综合医院管理评价中的应用研究  

Study on Application of DRGs in Management Evaluation of a Tertiary General Hospital

作　　者：王海英 周子君[1] 赵同香[2] 薄天慧[2] 王悦[2] 刘薇[2] 张秀英[2] WANG Hai-ying;ZHOU Zi-jun;ZHAO Tong-xiang;BO Tian-hui;WANG Yue;LIU Wei;ZHANG Xiu-ying(School of Public Health,Peking University;Peking University Shougang Hospital)

机构地区：[1]北京大学公共卫生学院 [2]北京大学首钢医院

出　　处：《医院管理论坛》2020年第7期5-8,共4页Hospital Management Forum

摘　　要：目的探索疾病诊断相关组(Diagnosis Related Groups,DRGs)在三级综合医院精细化管理评价中的应用。方法以某三级综合医院为例,运用DRGs评价体系,对2017年和2018年出院并符合纳入DRGs的病例,从服务能力、服务效率、质量安全三个维度进行医院、科室、医生三个层面的评价。结果2018年出院病例数34237例,DRGs组数611个、病例组合指数值(Case mix index,CMI)1.08,分别较2017年增长了1.16%、2.86%;费用消耗指数(Cost consumption index,CCI)1.00、时间消耗指数(Time consumption index,TCI)1.04,分别较2017年下降了12.28%、4.59%;低风险死亡率(Low riskmortality,LRM)0.03%与2017年一致。按照综合评分法对科室和医生进行评价排序:GK科评分10.00位居手术类科室第一名,SNK科评分6.54位居非手术类科室第一名,BETR医生评分19.65,在126名医生中排名第一。结论DRGs可以对医院、科室、医生的医疗服务能力做出全面、客观、公平的评价,为三级综合医院精细化管理提供了切实可行的评价方法。Objective To explore the application of Diagnosis Related Groups(DRGs)in the fine management evaluation of the tertiary general hospital.Method Taking a tertiary general hospital as example,the DRGs evaluation system was used to evaluate the discharged cases eligible for DRGs in 2017 and 2018 from the three dimensions of service capacity,service efficiency,quality safety and from three levels of hospital,departments,and doctors.Results In 2018,the number of discharged cases was 34237,DRGs 611,and Case mix index(CMI)1.08,which were1.16%and 2.86%higher than those of 2018,respectively;Cost consumption index(CCI)1.00,TCI 1.04,which were 12.28%and 4.59%lower than those in 2017,respectively;Low risk mortality(LRM)was 0.03%,which was the same as that in 2017.The departments and doctors were ranked according to the comprehensive score,and GK Department ranked first in the surgical departments with the score of 10.00,SNK department(6.54)ranked first in the non-surgical department,and BETR doctor(19.65)ranked first in 126 doctors.Conclusion DRGs can make a comprehensive,objective and fair evaluation of the medical service capacity of the hospital,departments and doctors,and provide a feasible evaluation method for the fine management in tertiary general hospital.

关 键 词：诊断相关组 评价 医院 精细化管理 

分 类 号：R197.3[医药卫生—卫生事业管理]