数字化赋能全流程DRG运营管理的探索与实践  

Exploration and practice of digitization enabling whole-process DRG operation management

作　　者：李盈[1] 金雯[1] 倪剑 顾国煜[1] LI Ying;JIN Wen;NI Jian;GU Guoyu(The First Affiliated Hospital,College of Medicine,Zhejiang University,Hangzhou 310003,Zhejiang Province,China)

机构地区：[1]浙江大学医学院附属第一医院,杭州310003

出　　处：《中国数字医学》2023年第2期21-26,共6页China Digital Medicine

摘　　要：目的:建设业务一体化、数据互联互通的医院数字化信息系统平台,实现全流程DRG数据管理,以信息化助力医院智慧运营。方法:通过搭建数据中台,实现多系统集成和信息互联互通,优化数据质控体系,夯实信息化建设基石,构建医院DRG智慧运营系统,实现数据可视化呈现和交互分析,助力运营效率的精细化管理和决策。结果:医院DRG智慧运营系统应用后,2021年我院住院医保患者高倍率及低倍率占比均下降;住院均次费用、药占比、耗材占比、平均住院日、术前待床日较去年同期明显下降,CMI及疑难病例(RW≥2)占比、全院DRG组病组覆盖率同比均增加,临床学科发展更均衡。结论:DRG智慧运营系统能满足以数字化信息系统建设助力医院DRG精细化运营管理的需求,推动智慧医院建设,促进医院高质量发展。Objective To build a hospital digital information system platform with business integration and data interconnection,to realize the whole-process DRG data management,and to help the hospital intelligent operation with informatization.Methods A data center was built to realize multi-system integration and information interconnection,and to optimize the data quality control system and consolidating the cornerstone of information construction.The whole-process DRG operation management system was built to realize data visualization and interactive analysis,and help refine management and decision making of operation efficiency.Results After the application of the hospital DRG intelligent operation system,the proportions of high and low rate of our inpatients with medical insurance were decreased in 2021,and the average cost of hospitalization,drug ratio,consumables ratio,average hospitalization days,and preoperative waiting days were decreased significantly compared with the same period last year.CMI,the proportion of difficult cases(RW≥2)and the coverage rate of DRG groups in the whole hospital increased year on year,and the development of clinical disciplines was more balanced.Conclusion DRG operation management model can meet the demand of refining operation and management of hospital DRG with digital information system construction,promote the construction of smart hospital and facilitate its high quality development.

关 键 词：全流程 疾病诊断相关分组 数字化 运营管理 智慧医院 

分 类 号：R-056[医药卫生]