疾病诊断相关分组在青海省某三甲综合医院住院医疗服务绩效评价中的应用研究  

Application study of disease diagnosis-related groups in performance evaluation of inpatient medical services in a third-grade general hospital in Qinghai Province

作　　者：李豪杰 祁永梅 王鑫[1] 付锐森 董海波[1] 张玉清[1] LI Haojie;QI Yongmei;WANG Xin;FU Ruisen;DONG Haibo;ZHANG Yuqing(Medical Quality Management Office,Qinghai Provincial People’s Hospital,Qinghai Province,Xining810000,China)

机构地区：[1]青海省人民医院质管办,青海西宁810000

出　　处：《中国医药导报》2022年第28期158-161,共4页China Medical Herald

基　　金：青海省卫生健康系统指导性计划课题(2020-wjzdx-44)。

摘　　要：目的探究疾病诊断相关分组(DRGs)在三甲综合医院医疗服务绩效评价中的应用,为医院管理决策提供询证依据。方法以青海省人民医院住院医疗服务评价系统为依托,采集该医院2019年1月—2020年12月住院患者的总权重、病例组合指数(CMI)、效率分数等指标,从服务能力、服务效率、服务质量三个维度进行医疗服务绩效评价及比较分析。结果2019—2020年该医院总权重减少了5421.00,CMI值增加了0.06;时间消耗指数上升了0.01,费用消耗指数下降了0.04,但效率分数上升了0.02;低风险死亡率下降了0.02。多数科室总权重下降,CMI值升高,服务效率升高,低风险死亡率下降。与平均水平比较,神经外科和肿瘤外科科室管理能力不足。结论DRGs绩效评价指标具有合理公平、客观可比的特点,能够反映医院、科室的实际情况,为实现医院精细化管理和优化资源配置提供数据支撑。Objective To explore the application of disease diagnosis-related groups(DRGs)in the performance evaluation of medical services in tertiary general hospitals,and to provide evidence-based evidence for hospital management decision-making.Methods Relying on the inpatient medical service evaluation system of Qinghai Provincial People’s Hospital,the total weight,case mix index(CMI),efficiency score,and other indicators of the hospital’s inpatients from January 2019 to December 2020 were collected.From the three dimensions of service capability,service efficiency,and service quality,medical service performance evaluation and comparative analysis were carried out.Results From 2019 to 2020,the total weight of the hospital decreased by 5421.00,and the CMI value increased by 0.06;the time consumption index increased by 0.01,the cost consumption index decreased by 0.04,but the efficiency score increased by 0.02;the low-risk mortality rate decreased by 0.02.The total weight of most departments was decreased,the CMI value was increased,the service efficiency increased,and the low-risk mortality rate was decreased.Compared with the average level,the neurosurgery and surgical oncology departments had insufficient management capacity.Conclusion DRGs performance evaluation indicators are reasonable,fair,and objectively comparable,which can reflect the actual situation of hospitals and departments,and provide data support for the realization of refined hospital management and optimization of resource allocation.

关 键 词：疾病诊断相关分组 住院医疗服务 绩效评价 

分 类 号：R197[医药卫生—卫生事业管理]