某省2018年基于DRG的医疗能力评价及病种分析  

Based on DRG Medical Capacity Evaluation and Disease Analysis of One Province in 2018

作　　者：陈媛 文小焱 陈俐[1] Chen Yuan;Wen Xiaoyan;Chen Li(Chengdu Third People's Hospital,Chengdu 610031,Sichuan Province,China;不详)

机构地区：[1]成都市第三人民医院,四川省成都市610031

出　　处：《中国病案》2021年第10期12-15,共4页Chinese Medical Record

摘　　要：目的应用DRG对医疗机构及地区间医疗服务能力进行评价,以期为医疗机构提升内部服务水平、优化病种结构,提供数据支持。方法采用2018年1月1日-2018年12月31日某省二级及以上综合医院出院患者病案首页数据,采用描述性统计分析方法对某省DRG部分指标如RW、CMI、DRGs组数进行统计分析;采用某省各病组出院人数构成比及累计构成比分析出院人数、权重及死亡人数前十的病种。结果某省二级及以上综合医院2018年总权重为5902630.5,CMI值为0.85,DRGs组数为745;地区分布中,某省2018年大部分地区DRGs组数主要集中690-710组之间,CMI值主要集中于0.80-0.87之间,CMI值最高A地区为0.95,U地区最低为0.61;医疗服务能力综合评分中,A地区评分最高为70分,大部分地区评分主要集中于40~50分之间;病组分析结果显示,慢性阻塞性肺病出院人数、死亡人数及总权重均排在前列,占比较高。结论2018年某省医疗服务能力地区差异较大;慢性阻塞性肺病为该省多发病、常见病,病死率较高疾病,且其住院直接经济负担较重;DRG可客观评价医疗机构间以及医疗机构内部服务能力水平,优化病种结构。Objective DRG is applied to evaluate the medical service capacity of medical institutions and regions,in order to improve the internal service level,optimize the disease structure and provide data support for medical institutions.Methods The data of the first page of medical records of discharged patients in a provincial general hospital of grade II and above from January 1,2018 to December 31,2018 were used to analyze some indexes of DRG in a province,such as RW,CMI and DRGs groups,and the constituent ratio and cumulative constituent ratio of patients discharged from hospital in a province were used to analyze the top ten diseases of discharge,weight and death.Results The total weight of a provincial general hospital in 2018 was 5902630.5,CMI value was 0.85,DRG groups was 745;In regional distribution,DRG group was mainly between 690 and 710 in most areas of a province in 2018,CMI value was mainly between 0.80 and 0.87,CMI value was 0.95 in A region and 0.61 in U region;In the comprehensive score of medical capacity,the highest score was 70.The scores in most areas were mainly between 40 and 50 points,and the results of disease group analysis showed that the number of discharged patients,the number of deaths and the total weight of ranked first,accounting for a higher proportion.Conclusion There are great regional differences in medical service capacity in a province in 2018.Chronic obstructive pulmonary disease(COPD)is a common and frequently occurring disease in the province,with a high mortality rate and a heavy direct economic burden on hospitalization;DRGs can objectively evaluate the level of service capacity of medical institutions and optimize the structure of diseases.

关 键 词：DRG 医疗服务能力 病种 

分 类 号：R197.323[医药卫生—卫生事业管理]