基于床位效能评价优化综合医院床位配置的应用研究  

Application of bed allocation optimization in general hospital based on bed effectiveness evaluation

作　　者：阳雅雯 江涛[1] 杨翠[1] YANG Ya-wen;JIANG Tao;YANG Cui(West China Hospital,Sichuan University,Chengdu,Sichuan 610041,China)

机构地区：[1]四川大学华西医院,四川成都610041

出　　处：《现代预防医学》2021年第22期4219-4224,共6页Modern Preventive Medicine

基　　金：四川省科学技术厅软科学项目(2020JDR0101)。

摘　　要：目的运用疾病诊断相关组(diagnosis related groups)DRG指标作为医院医疗服务能力评价指标,结合病床运行效率综合评价单位病床利用效能,为医院床位合理配置提供决策依据。方法以某三级甲等医院2019年运行数据及DRG数据为基础,以病床周转次数及病床占用率绘制科室病床运行效率散点图;以单床年DRG权重为产出指标,结合科室病例组合指数(case mix index)CMI值绘制病床产出效能散点图;结合运行效率及产出效率综合评价科室病床利用效能并将其分为A、B、C、D、E五类。分别利用病床工作效率指标及病床产出效率指标95%CI计算各科室病床数的合理区间。结果 39个临床科室中,病床利用效能综合评价为A类有5个科室、B类科室14个、C类科室3个、D类科室10个、E类科室7个。有6个科室实际开放床位较为合理,病床工作效率与病床产出效率判定结果均为合适,14个科室的判定结果均为偏多,5个科室的判定结果均为偏少,余14个科室的床位配置判定结果发生了变化。结论结合DRG指标与传统运行效率指标对医院科室床位利用效能进行综合评价兼顾了效率和质量,其结果更为全面、客观;可为医院调整内部结构,优化床位配置提供科学依据,助力医院精细化管理。Objective To use the diagnosis related groups(DRG) index as an evaluation index of hospital medical service capacity,combine with bed operation efficiency to comprehensively evaluate the effectiveness of unit bed utilization,and provide a decision basis for reasonable hospital bed allocation.Methods Based on the 2019 operational data and DRG data of a tertiary care hospital,a scatter plot of unit bed operational efficiency was drawn with the number of bed turnover and bed occupancy rate.The annual DRG weight of a single bed was used as the output index,and the case mix index(CMI) of the unit was combined to draw a scatter plot of bed output efficiency.The efficiency of bed utilization in the department was evaluated by combining the operational efficiency and output efficiency and classified into five categories:A,B,C,D and E.The 95% CI of bed efficiency index and bed output efficiency index were used to calculate the reasonable interval of the number of beds in each department,respectively.Results Among the 39 clinical departments,there were five departments in category A,14 in category B,three in category C,10 in category D,and seven in category E.The actual number of open beds in six departments was reasonable,the results of bed efficiency and bed output efficiency were judged to be appropriate,the results of 14 departments were judged to be excessive,the results of five departments were judged to be insufficient,and the results of the remaining 14 departments’ bed configuration changed.Conclusion Combining DRG index and traditional operational efficiency index for comprehensive evaluation of bed utilization effectiveness of hospital departments takes into account efficiency and quality,and the results are more comprehensive and objective.It can provide scientific basis for hospitals to adjust internal structure and optimize bed allocation,and help hospitals refine management.

关 键 词：疾病诊断相关分组 病床运行效率 床年DRG权重 病床利用效能 优化床位配置 

分 类 号：R197.3[医药卫生—卫生事业管理]