基于熵权法的DRG综合评价在三级综合医院中的应用  

Application of DRG comprehensive evaluation based on entropy weight method in GradeⅢgeneral hospitals

作　　者：孙鹏鹤 赵宁 陈婷[1] SUN Penghe;ZHAO Ning;CHEN Ting(School of Public Health,Wuhan University of Science and Technology,Wuhan,Hubei Province,430065,PRC;不详)

机构地区：[1]武汉科技大学公共卫生学院,湖北省武汉市430065 [2]清华大学医院管理研究院,北京市100089

出　　处：《中国医院》2023年第10期56-59,共4页Chinese Hospitals

基　　金：国家社科基金国家应急管理体系建设研究专项(20VYJ067)。

摘　　要：目的:基于三级综合医院的文献数据探索,提高DRG用于医疗服务绩效评价的客观应用价值。方法:以《2020国家医疗服务与质量安全报告》为基础,将DRG指标分为医疗服务能力、医疗服务效率及医疗安全3个维度,搜集整理纳入164家三级综合医院数据,标准化后采用熵权法计算指标权重,并对三级综合医院DRG绩效进行综合评价。结果:3个维度中,医疗服务能力权重最高(0.5544)、医疗效率能力权重次之(0.4035)、医疗安全权重最低(0.0421);二级指标权重由高到低依次是CMI(0.3519)、时间消耗指数(0.2274)、DRG组数(0.2025)、费用消耗指数(0.1761)和低风险组死亡率(0.0421);164家医院的DRG综合评分最高为0.8792,最低为0.2399,中位数为0.6618。结论:三级综合医院在进行DRG服务绩效评价时,应侧重于医疗服务能力与医疗服务效率两个维度,医疗安全维度因其“低风险组死亡率”的敏感程度,在使用该指标时要加强对医院的监管,减少瞒报造假等情况的发生。Objective:To improve the objective application value of DRG in medical service performance evaluation,this paper explores the literature data on GradeⅢgeneral hospitals.Methods:Based on the 2020 National Medical Service and Quality Safety Report,DRG indicators were divided into three dimensions:medical service capacity,medical service efficiency,and medical safety.Data from 164 GradeⅢgeneral hospitals were collected,sorted,and included.After standardization,the entropy weight method was used to calculate the index weight and a comprehensive evaluation of the DRG performance of GradeⅢgeneral hospitals was conducted.Results:Among the three dimensions,the weight of medical service capability is the highest(0.5544),followed by the weight of medical efficiency capability(0.4035)and the weight of medical safety(0.0421).The weight of secondary indexes from high to low was CMI(0.3519),time consumption index(0.2274),DRG group number(0.2025),cost consumption index(0.1761),and mortality rate of the low-risk group(0.0421).The median comprehensive DRG score of 164 hospitals was 0.6618(minimum 0.2399,maximum 0.879225).Conclusion:When evaluating the service performance of DRG,GradeⅢgeneral hospitals should focus on two dimensions:medical service capacity and medical service efficiency.Because of the sensitivity of the"low-risk group mortality",the medical security dimension should strengthen the supervision of hospitals when using this indicator to reduce the occurrence of fraud.

关 键 词：熵权法 DRG 绩效管理 医院评价 绩效评价 

分 类 号：R197.3[医药卫生—卫生事业管理]