2015-2020年江西省直属三甲综合医院医疗绩效评价研究  

Research on the medical performance evaluation of the provincial Grade Ⅲ general hospitals of Jiangxi Province from 2015 to 2020

作　　者：付铭 甘少辉 陈梦群 高兴 周小军[1,2] 廖玉翠 程学新 FU Ming;GAN Shaohui;CHEN Mengqun;GAO Xing;ZHOU Xiaojun;LIAO Yucui;CHENG Xuexin(School of Public Health,Nanchang University,Nanchang,Jiangxi Province,330006,PRC)

机构地区：[1]南昌大学公共卫生学院,江西省南昌市330006 [2]江西省预防医学重点实验室,江西省南昌市330006 [3]南昌大学第二附属医院,江西省南昌市330006

出　　处：《中国医院》2022年第4期5-7,共3页Chinese Hospitals

基　　金：江西省自然科学基金基础研究计划-管理科学类(20202BAA208015)。

摘　　要：目的:通过对2015-2020年江西省3所省属三甲综合医院医疗服务绩效进行综合评价,助力医院管理决策。方法:通过江西省DRGs平台分析3所省属三甲综合医院2015-2020年2026804条出院患者病案首页信息,以DRG总量、病例组合指数、DRG组数、时间指数、费用指数和低风险死亡率为评价指标,使用加权TOPSIS、RSR法对3所省属三甲综合医院2015-2020年医疗绩效进行评价并分档,用综合评分法计算年份综合得分与医院综合得分。结果:18个评价对象划分为好、较好、一般、较差、差5档,各档间差异有统计学意义(F=52.964,P<0.01)。年份综合评分呈现出2015-2017年降低、2017-2020年升高的趋势,2020年评分最高(14分),2017年评分最低(5分)。医院综合评分B医院最高(22分),A医院其次(15分),C医院最低(12分)。结论:基于DRGs指标,运用加权TOPSIS联合RSR法进行医疗绩效综合评价,能考虑医院历年发展因素,从而更加科学、综合地反映医疗服务情况。同时建议卫生管理部门继续深入推广DRGs绩效考核工作,促进江西省整体医疗服务水平持续提升。Objective:To assist hospital management decision-making by comprehensively evaluating the medical service performance of 3 provincial Grade Ⅲ general hospitals in Jiangxi Province from 2015 to 2020.Methods:Through the Jiangxi DRGs platform,the first page information of 2,026,804 discharged patients’ medical records from 2015-2020 in 3 provincial Grade Ⅲ general hospitals was analyzed based on the total amount of DRG,case mix index (CMI),number of DRG groups,time index,cost index and low risk mortality rate.The weighted TOPSIS and RSR methods are used to evaluate and classify the medical performance of three provincial Grade Ⅲ general hospitals from 2015 to 2020.The comprehensive score method is used to calculate the comprehensive score of the year and the comprehensive score of the hospital.Results:The 18 evaluation objects were divided into five grades:which are the best level(2),the better level(4),the general level(5),the worse level(4),and the worst level(3).The difference between each grade was statistically significant (F=52.964,P<0.01).The overall score of the year showed a trend of decreasing from 2015 to 2017 and increasing from 2017 to 2020.The score in 2020 was the highest with 14 points,and the score in 2017 was the lowest with 5 points.Hospital B had the highest comprehensive score with 22 points,A hospital followed by 15 points,and C hospital had the lowest score with 12 points.Conclusion:Based on DRGs indicators,the use of weighted TOPSIS combined with the RSR method for comprehensive evaluation of medical performance can take into account the development factors of the hospital over the years,so as to more scientifically and comprehensively reflect the medical service situation.At the same time,it is recommended that the health management department continue to promote DRGs performance appraisal work in depth to promote the continuous improvement of the overall medical service level in Jiangxi Province.

关 键 词：TOPSIS法 RSR法 DRGS 综合评价 医疗服务绩效 

分 类 号：R197[医药卫生—卫生事业管理]