应用时间基础率优化病种结构的探讨  

Optimization of Disease Structure Based on Time Based Rate

作　　者：徐周 张正宇 金雯[1] 李盈[1] 王楼蕾[1] 陈筵明 XU Zhou;ZHANG Zhengyu;JIN Wen;LI Ying;WANG Loulei;CHEN Yanming(Medical Record Department,The First Affiliated Hospital of Zhejiang University,Hangzhou,Zhejiang,310003;Quality Management Department,Ningbo Beilun People’s Hospital,Ningbo,Zhejiang,315000)

机构地区：[1]浙江大学医学院附属第一医院病案室,浙江杭州310003 [2]宁波市北仑区人民医院质量管理部,浙江宁波315000

出　　处：《江苏卫生事业管理》2022年第8期1043-1047,共5页Jiangsu Health System Management

基　　金：2020年浙江省医药卫生科技项目(2020KY561)。

摘　　要：目的:通过时间基础率测算并调整病种结构,提高医疗效率。方法:确定68个重点监测病种/术种的全省平均住院日标杆值ALOS和所在DRG组的平均疑难度CMI,测算各病种/术种的全省标杆时间基础率ALOS/CMI并排序。结果:2019年S院有48个重点监测病种/术种的时间基础率低于全院时间基础率(6.2080),诊治效率高且疾病难度大。通过优化调整上述病种结构,2021年S院时间基础率下降到5.0846,68个病种/术种中有39个的时间基础率低于2019年Z省标杆时间基础率。结论:时间基础率可作为病种结构调整依据,通过资源配置倾斜和向标杆医院学习等举措精准化提质增效。Objectives:To improve the medical efficiency by calculating the time based rate and adjusting the disease structure.Methods:The provincial benchmark value ALOS of 68 key monitored diseases/operations and the average difficulty of suspicion CMI of DRG groups were determined,and the provincial benchmark time based rate ALOS/CMI of each disease/operation was calculated and ranked.Results:In 2019,the time based rate of 48 key monitored diseases/operations in our hospital was lower than that of the whole hospital(6.2080).The diagnosis and treatment efficiency was high and the disease was difficult.By optimizing and adjusting the structure of the above diseases,the time based rate of the whole hospital was reduced to 5.0846 in 2021,and the time based rate of 39of the 68 diseases/operations were lower than the benchmark time based rate of the whole province in 2019.Conclusion:The time based rate can be used as the basis for the structural adjustment of diseases,and the quality and efficiency can be improved through measures such as resource allocation and learning from benchmark hospitals.

关 键 词：时间基础率 DRG 平均住院日 

分 类 号：R197.39[医药卫生—卫生事业管理]