基于DRG的省域儿科住院医疗服务绩效评价研究  

Research on the Performance Evaluation of Provincial Pediatric Inpatient Medical Service Based on DRG

作　　者：邵颖颖 刘建军[2] 李曰阳 钟正东 SHAO Yingying(Wuhan NO.1 Hospital,Wuhan,Hubei,430000,China)

机构地区：[1]武汉市第一医院,湖北武汉430000 [2]华中科技大学同济医学院附属武汉儿童医院,湖北武汉430014 [3]华中科技大学医药卫生管理学院,湖北武汉430000

出　　处：《医学与社会》2021年第12期45-48,54,共5页Medicine and Society

基　　金：国家自然科学基金资助项目,编号为71874058、72174068。

摘　　要：目的:以DRG指标为基础评价某省16个地市(省直管市)的儿科住院医疗服务绩效情况,为我国DRG宏观层面的多维度绩效评价提供参考。方法:对某省全部医疗机构病案信息系统上报的儿科住院患者病案数据,从服务能力、服务效率和医疗安全等3个维度进行绩效评价。结果:5个地区CMI远低于全省平均值;1个地区费用和住院时间控制较差,11个地区住院时间控制较差;6个地区出现低风险组死亡,3个地区高风险组死亡率较高。结论:某省区域间儿科医疗服务发展不均衡;医疗服务能力区域不均衡可能导致低公平效率问题;大多数地区服务效率需要提高;低风险死亡率指标反映儿科医疗服务质量还存在一定问题;需针对不同地区从病案数据管理、能力、效率、质量等多个维度进行综合分析与管理决策。Objective:To evaluate the performance of pediatric inpatient medical services in 16 cities in a province based on DRG indicators.To provide reference suggestions for the multi-dimensional performance evaluation of China's DRG at the macro level.Methods:The medical record data of pediatric inpatients reported by the medical record information system of all hospitals in a certain province was evaluated for performance from 3 dimensions including service capacity,service efficiency and medical safety.Results:CMI in 5 regions was much lower than the average value of the whole province.1 region had poor cost control and length of stay in hospital,11 regions had poor control of length of stay in hospital,and low-risk deaths appeared in 6 regions,and 3 regions have High-risk deaths rates.Conclusion:The development of pediatric medical services in a province is uneven.Regional imbalances in medical service capabilities may lead to low equity and efficiency problems.Service efficiency in most regions needs to be improved.Low-risk mortality indicators reflect that there are still problems in the quality of pediatric medical services.Comprehensive analysis and management decision-making from multiple dimensions such as medical record data management,capacity,efficiency,and quality are required for different regions.

关 键 词：DRG 儿科 综合评价 省域 

分 类 号：R195[医药卫生—卫生统计学]