DRG+RBRVS视角下护理精细化绩效管理方案的探索  

Exploration on nursing fine performance management scheme from perspective of DRG and RBRVS

作　　者：郭静[1] 吴艳[1] 何娟[1] 陈瑞[1] 陈霞[1] GUO Jing;WU Yan;HE Juan;CHEN Rui;CHEN Xia(The First Affiliated Hospital of Xinjiang Medical University,Xinjiang 830011 China)

机构地区：[1]新疆医科大学第一附属医院,新疆830011

出　　处：《护理研究》2022年第21期3775-3780,共6页Chinese Nursing Research

基　　金：新疆维吾尔自治区自然科学基金资助项目,编号:2020D01C241。

摘　　要：目的:总结基于疾病及相关诊断分组(DRG)与以资源为基础的价值相对系数(RBRVS)特色,分析不同护理绩效测算方案的优势与不足,为建立符合疾病特点与护理难度的绩效考核方案提供参考。方法:以某院26个护理单元(内科11个、外科11个、重症4个)2019年1月1日—2020年12月31日的出院病人服务数据为评价对象,分别以RBRVS、DRG、DRG+RBRVS建立评价模型,进行护理绩效测算。结果:26个参评护理单元中,内科平均病例组合指数(CMI)为2.88,外科平均CMI为6.61,重症科室平均CMI为11.10。内科DRG平均组数83组,外科平均71组,重症科室平均13组。模型一:平均绩效45323元/单元、7921元/人;内科38253元/单元,外科42509元/单元,重症病房72502元/单元。模型二:平均绩效38515元/单元、6621元/人;内科30354元/单元,外科46761元/单元,重症病房38280元/单元。模型三:平均绩效43899元/单元、7112元/人;内科31322元/单元,外科45727元/单元,重症病房65213元/单元。结论:DRG+RBRVS在兼顾疾病难度与护理项目质量基础上丰富了绩效考评机制,在应用过程中,应重视病案首页填写缺陷导致护理绩效评价下降的情况。Objective:It summarized the characteristics of DRG and RBRVS,and analyzed the advantages and disadvantages of different nursing performance measurement schemes,so as to provide references for establishing a performance evaluation scheme in line with disease characteristics and nursing difficulty.Methods:Taking the service data of patients discharged from 26 nursing units(11 internal departments,11 surgery departments and 4 severe departments)from January 1,2019 to December 31,2020 as the evaluation object,the evaluation models were established with RBRVS,DRG and DRG+RBRVS respectively to calculate the nursing performance.Results:Among the 26 participating nursing units,the average CMI of internal department,surgery department and sever departments were 2.88,6.61,11.10,respectively.The average number of DRG groups was 83 in internal department,71 in surgery department and 13 in severe departments.Model 1:average performance 45323 yuan/unit,7921 yuan/person;internal departments 38253 yuan/unit,surgery departments 42509 yuan/unit,severe 72502 yuan/unit.Model 2:average performance:38515 yuan/unit,6621 yuan/person;30354 yuan/unit for internal depa r tm en ts,46761 yuan/unit fo r su rge ry depa r tm en ts and 38280 yuan/unit fo r seve re departments.Model 3:average performance 43899 yuan/unit,7112 yuan/person;31322 yuan/unit for internal departments,45727 yuan/unit for surgery departments and 65213 yuan/unit for severe depa r tm en ts.Conclusion:DRG+RBRVS enriches the performance evaluation mechanism based on the consideration of disease difficulty and nursing project quality.Attention should be paid to the decline of nursing performance evaluation caused by the defect in filling in the first page of medical records.

关 键 词：疾病及诊断相关分组 资源相对价值系数 护理绩效 方案评价 护理管理 

分 类 号：R47[医药卫生—护理学]