收治病种结构对医院CMI值的影响  

The Influence of Hospital Structure on CMI Value

作　　者：廖慧群 麦紫娟 廖彩霞 Liao Huiqun;Mai Zijuan;Liao Caixia(Medical Records Statistics Department,University of Chinese Academy of Sciences-Shenzhen Hospital,Shenzhen518106,Guangdong Province,China)

机构地区：[1]中国科学院大学深圳医院(光明)信息服务部病案统计办,广东省深圳市518106

出　　处：《中国病案》2022年第1期10-12,共3页Chinese Medical Record

基　　金：光明区经济发展专项资金(项目编号:2021R01138)。

摘　　要：目的评估收治病种结构改变对CMI值的影响,为医院提高医疗质量和效率提供参考。方法将改革前2020年1月1日-2020年6月30日20916住院人次,以及改革后2020年7月1日-2020年12月31日25619住院人次作为研究对象。通过完善双向转诊模式、加强住院病案首页培训、坚持医保惠民政策及开展专科疑难技术等举措后,对RW<0.5人次变动、DRG与绩效考核相关指标、RW<0.5和RW≥0.5人次、平均疾病诊断个数、平均手术与操作个数等方面进行差异比较。结果改革前后10个RW<0.5的DRG组人次对比,均为P<0.05有统计学意义。改革前DRG组数从604组上升到改革后648组,CMI值从0.93提高至1.11。下转人次增长54.05%,日间手术人次增长262.60%。改革前后出院患者RW<0.5与RW≥1.5相比,P<0.05有统计学意义。改革前RW≥1.5人次占比为10.85%,改革后占比上升到15.97%。改革后入组患者的平均疾病诊断个数为(3.80±3.51),平均手术与操作个数为(2.15±3.31),与改革前相比,P<0.05。结论借助三级综合医院评审标准和DRG评价体系,改变收治病种结构,提升收治疑难杂症患者能力,推动医院绩效考核,实现医院效率提高和质量提升。Objectives To evaluate the influence of structural changes of treated diseases on CMI value.Methods A total of 20,916 inpatients were enrolled from January 1,2020 to June 30,2020 before the reform,and 25,619 inpatients were enrolled from July 1 st,2020 to December 31 st,2020 after the reform.After improving the two-way referral mode,strengthening the training of medical record first page,adhering to the policy of benefiting the people in medical insurance and developing specialized difficult technology,the differences of RW<0.5 person-times,DRG and performance assessment indicators,RW<0.5 and RW≥0.5 person-times,average number of disease diagnoses,average number of surgeries and operations were compared.Results The person-times of 10 DRG groups with RW<0.5 before and after reform were all p<0.05,which was statistically significant.The number of DRG groups increased from 604 before reform to 648 after reform,and the CMI value increased from 0.93 to 1.11.The number of referrals increased by 54.05%,and the number of day surgeries increased by 262.60%.RW<0.5 of discharged patients before and after reform was statistically significant compared with RW≥1.5.Before the reform,the proportion of RW≥1.5 was 10.85%,and after the reform,the proportion rose to 15.97%.After the reform,the average number of disease diagnoses and operations was 3.80±3.51 and 2.15±3.31,respectively,compared with before the reform,P<0.05.Conclusions With the help of the evaluation standard and DRG evaluation system of tertiary general hospitals,the structure of treating diseases was changed,the ability of treating patients with difficult and miscellaneous diseases was improved,and the hospital performance evaluation was promoted to improve the efficiency and quality of the hospital.

关 键 词：CMI RW DRG 病种结构 双向转诊 分级诊疗 

分 类 号：R197.32[医药卫生—卫生事业管理]