江西省县级医院医疗服务绩效动态评价研究  

Research on dynamic evaluation of medical service performance of county-level hospitals in Jiangxi Province based on panel data

作　　者：袁萍[1,2,3] 付铭 廖玉翠 路佳 张慧 黄奕婷 程学新 YUAN Ping;FU Ming;LIAO Yucui;LU Jia;ZHANG Hui;HUANG Yiting;CHENG Xuexin(School of Public Health,Nanchang University,Nanchang,Jiangxi Province,330006,PRC;不详)

机构地区：[1]南昌大学公共卫生学院,江西省南昌市330006 [2]江西省预防医学重点实验室,江西省南昌市330006 [3]南昌大学第二附属医院,江西省南昌市330006

出　　处：《中国医院》2023年第10期11-14,共4页Chinese Hospitals

基　　金：江西省自然科学基金基础研究计划-管理科学类(20202BAA208015)。

摘　　要：目的:对江西省县级公立综合医院进行医疗服务绩效动态评价,了解其2019-2021年医疗服务绩效水平的变化情况,为改善县级医院服务水平提供参考。方法:以江西省县级公立医院为研究对象,从医疗服务能力、效率和质量3个维度,选取DRG总量、DRG组数、CMI值、费用消耗指数、时间消耗指数以及低风险死亡率6项指标,在截面数据中引入时序,建立面板数据集,运用熵权法确定指标权重,TOPSIS法进行动态排序,RSR法进行分档,对2019-2021年的医疗服务绩效进行横向与纵向分析。结果:熵权法结果显示各指标熵值均大于0.99,费用消耗指数权重最大,为0.2321;TOPSIS法中各医院历年排名小幅波动,Ci均值为0.4646、0.5048、0.5567;RSR分档结果中共4个评价对象为差档,5个为优档,其余为中档。结论:从整体上看,江西省县级公立医院医疗服务绩效水平总体向好,但县域之间差距较大,部分县级医院医疗服务水平仍有待改善。Objective:To evaluate the dynamic performance of medical services in county-level public general hospitals in Jiangxi Province,to understand the changes in medical service performance in 2019-2021,and to provide a reference for improving the service level of county-level hospitals.Methods:Taking county-level public hospitals in Jiangxi Province as the research object,six indicators of total DRG,number of DRG groups,CMI value,cost consumption index,time consumption index and low-risk mortality were selected from the three dimensions of medical service capacity,efficiency and quality,and time series were introduced into the cross-sectional data,panel data sets were established,the index weights were determined by the entropy weight method,the TOPSIS method was dynamically ranked,and the RSR method was divided into bins,and the medical service performance from 2019 to 2021 was analyzed horizontally and vertically.Results:The results of the entropy weight method showed that the entropy value of each index was greater than 0.99,and the weight of the cost consumption index was the largest,which was 0.2321;the ranking of hospitals in the TOPSIS method fluctuated slightly,with the mean values of C being 0.4646,0.5048 and 0.5567;the RSR classification results showed that a total of 4 evaluation objects were poor,5 were excellent,and the rest were medium-range.Conclusion:On the whole,the medical service performance of county-level public hospitals in Jiangxi Province is generally good,but there is a large gap between counties,and the medical service level of some county-level hospitals still needs to be improved.

关 键 词：县级医院 DRGS 医疗绩效 动态评价 

分 类 号：R197[医药卫生—卫生事业管理]