基于DRGs指标胃肠肿瘤外科医疗服务绩效评价研究  

Evaluation of the Health Service Performance of Gastrointestinal Tumor Surgery Department in Hospital Based on DRGs

作　　者：马学先[1] 张春华[2] 张文斌[2] MA Xuexian;ZHANG Chunhua;ZHANG Wenbin(Department of Infection Management,The First Affiliated Hospital of Xinjiang Medical University,Urumqi Xinjiang 830000,China;Department of Quality Management,The First Affiliated Hospital of Xinjiang Medical University,Urumqi Xinjiang 830000,China)

机构地区：[1]新疆医科大学第一附属医院感染管理科,新疆乌鲁木齐830000 [2]新疆医科大学第一附属医院质量管理科,新疆乌鲁木齐830000

出　　处：《中国卫生标准管理》2022年第13期85-88,共4页China Health Standard Management

摘　　要：目的探究疾病诊断相关分组(diagnosis related groups,DRGs)在胃肠肿瘤外科医疗服务绩效管理中的运用。方法依托新疆某医院绩效评价平台,调取在线上报的病案首页的数据,比较某院胃肠肿瘤外科2017年1月-2020年12月住院患者DRGs组数、病例组合指数(case-mix index,CMI)、费用消耗指数、时间消耗指数等指标,从服务能力、服务效率、医疗安全3个维度进行分析。结果2017—2020年该科DRGs组数增长了13个、CMI值提高了0.5192、总权重提高了658.93,平均住院日上升了5.03 d、平均总费用增加了24584.29元,平均耗材费增加了10935.22元,耗材费占比上升了9.89个百分点,时间消耗指数和费用消耗指数均呈上升的趋势;三四级手术率提高了37.51个百分点,微创手术率提高了11.71个百分点;但术后死亡率上升了0.06%,非计划再手术率上升了0.6%。结论胃肠肿瘤外科在提高外科服务能力的同时,要以DRGs评价为抓手,进一步加强患者的精细化管理,提高科室医疗服务能力和服务效率,保障患者安全。Objective To explore the application of diagnosis related groups(DRGs)in the performance management of gastrointestinal oncology surgery department.Methods Relying on the performance evaluation platform of a hospital in Xinjiang,the data on the homepage of the medical records reported online were retrieved,and the number of DRGs groups,the case-mix index(CMI),cost consumption index,time consumption index and other indicators of inpatients in the department of gastrointestinal oncology in a hospital from January 2017 to December 2020 were compared.Analyzed from three dimensions of service capability,service efficiency,and medical safety.Results From 2017 to 2020,DRG groups in the department increased by 13,CMI increased by 0.5192,the total weight increased by 658.93,the average hospital stay increased by 5.03 days,the average total cost increased 24584.29 yuan,the average consumables cost increased by 10935.22 yuan,and the proportion of consumables cost increased by 9.89 percentage points.Both the time consumption index and the cost consumption index were increased.The rate of three-four-stage surgery increased by 37.51%,the rate of minimally invasive surgery increased by 11.71%.But postoperative mortality rose by 0.06%,and unplanned reoperations rose by 0.6%.Conclusion While improve the surgical service ability,the gastrointestinal tumor surgery department should take DRGs as an effective starting point for management,further strengthen the delicacy management of patients,improve the medical service ability and efficiency of the department,and ensure the patient safety.

关 键 词：DRGS 胃肠肿瘤外科 绩效评价 精细化管理 医疗服务能力 患者安全 

分 类 号：R735[医药卫生—肿瘤]