机构地区:[1]广东省广州市番禺区中心医院信息统计中心,广东省广州市511400
出 处:《广西医学》2022年第18期2153-2158,共6页Guangxi Medical Journal
基 金:广东省广州市番禺区科技计划项目(2018-Z04-27)。
摘 要:目的 应用疾病诊断相关分组(DRG)评价广州某三级甲等综合医院外科科室的发展情况。方法 收集该医院2017~2019年期间6个外科科室(骨科、泌尿外科、普通外科、乳腺甲状腺外科、神经外科、心胸外科)出院患者病案首页数据,应用整体发展传统指标(出院人数、平均住院日、次均费用)和DRG评价指标[总权重、DRG组数、病例组合指数(CMI)、时间消耗指数、费用消耗指数、疑难病例占比及低风险组死亡率]描述外科科室发展情况,并对变化情况进行趋势检验。结果 (1)2017~2019年该院6个外科科室的出院人数有所增长,DRG组数、总权重逐年提升,平均住院日、CMI值、时间消耗指数、费用消耗指数、疑难病例占比呈下降趋势,次均费用呈上升趋势,6个外科科室均没有出现低风险组死亡。(2)2017~2019年,神经外科的CMI值最大,但出院人数最少;骨科收治的DRG组数有所减少,CMI值稳定维持在1.63~1.66之间,疑难病例占比呈逐年上升趋势;泌尿外科的时间消耗指数和费用消耗指数控制良好,均在平均水平以下;乳腺甲状腺外科收治的DRG组数最少,CMI值下降较明显;心胸外科出院人数增多,但CMI值下降明显,总权重降低;普通外科CMI值呈下降趋势,但疑难病例占比保持平稳。结论 通过应用DRG评价指标对广州某三级甲等综合医院的外科科室发展情况进行分析,能够发现科室发展所存在的问题,为制订科室发展计划提供参考依据。Objective To evaluate the development of surgical department in a tertiary general hospital in Guangzhou through applying diagnosis related group(DRG).Methods The home page data of medical records of patients discharged from 6 surgical departments(Departments of Orthopedics,Urinary Surgery,General Surgery,Breast and Thyroid Surgery,Neurosurgery,and Cardiothoracic Surgery) of the hospital during 2017 to 2019 was collected.Conventional indicators of overall development(the number of discharged patients,average length of hospital stay,average expense per time) and DRG evaluation indices(total weight,the number of DRG groups,Case-Mix Index [CMI],time consumption index,expense consumption index,and the proportion of difficult cases and mortality of the low-risk group) were applied to depict the development of surgical department,and the trend test was performed to the change conditions.Results From 2017 to 2019,the number of discharged patients in the six surgical departments of the hospital was increased,the number of groups and total weight of DRG increased year by year,the average length of hospital stay,CMI value,time consumption index,expense consumption index,and proportion of difficult cases exhibited a downward trend,and the average expense per time interpreted an upward trend.There was no death in the low-risk group in the six surgical departments.(2) From 2017 to 2019,the CMI value of Department of Neurosurgery was the largest,but the number of discharged patients was the lowest.The number of DRG groups admitted to the Department of Orthopedics were decreased,the CMI value remained stable between 1.63 and 1.66,and the proportion of difficult cases increased year by year.The time consumption index and expense consumption index of Department of Urology were well controlled and below the average level.The number of DRG groups admitted to Department of Breast and Thyroid Surgery was the least,and the CMI value was decreased significantly.The number of discharged patients in the Department of Cardiothoracic Surge
分 类 号:R197.1[医药卫生—卫生事业管理]
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