成都市三级综合医院医疗服务质量与绩效评价  

Evaluation of Healthcare Service Quality and Performance in Tertiary General Hospitals in Chengdu

作　　者：伍利香 田明政 王泺 吴妮 周晓媛[1] WU Lixiang(West China School of Public Health and West China Fourth Hospital,Sichuan University,Chengdu,Sichuan,610041,China)

机构地区：[1]四川大学华西公共卫生学院,四川大学华西第四医院,四川成都610041

出　　处：《医学与社会》2023年第11期71-76,共6页Medicine and Society

基　　金：国家重点研发计划“主动健康和老龄化科技应对”重点专项资助项目,编号为2020YFC2006500&2020YFC2006503;四川省科技厅软科学研究资助项目,编号为2015ZR0209。

摘　　要：目的:基于国家医疗保障疾病诊断相关分组(China healthcare security diagnosis related groups,CHS-DRG)付费数据评价成都市三级综合医院医疗服务质量与绩效水平,为提高医院服务质量、促进CHS-DRG更好地发挥作用提供参考。方法:收集成都市45家三级综合医院2021年CHS-DRG付费数据,采用熵权TOPSIS法对指标赋予权重并对CI值进行综合排序,再结合RSR法对评价结果进行分档。结果:熵值显示,药占比、住院次均费用、30天再住院率、时间消耗指数是权重最大的指标(0.082);排名最好和最差医院的CI值差值为0.23;从分档结果来看,第3档包括A1等8家医院(占比17.78%),第2档包括A26等30家医院(占比66.67%),第1档包括A39等7家医院(占比15.56%)。结论:成都市三级综合医院医疗服务质量整体较好,但各医院间存在不同程度的差异;排名靠后的医院要加强内部管理,提升服务能力和效率,实现高质量发展。Objective:This study assesses healthcare quality and performance in Chengdu's tertiary general hospitals,using real payment data from China's Healthcare Security Diagnosis Related Groups(CHS-DRG).The aim is to enhance service quality and the effectiveness of CHS-DRG.Methods:Payment data from 2021 were collected from 45 tertiary general hospitals in Chengdu.Using the entropy-weighted TOPSIS method,indicators were ranked and weighted to evaluate Ci values.The Rank Sum Ratio(RSR)method categorized the results.Results:Key indicators with highest weights(0.082)include medication costs,average inpatient cost per admission,30-day readmission rate,and time consumption.The difference in Ci values between highest and lowest ranked hospitals was 0.23.Categorized results:third tier(17.78%)included 8 hospitals(A1),second tier(66.67%)included 30 hospitals(A26),and first tier(15.56%)included 7 hospitals(A39).Conclusion:Overall,tertiary general hospitals in Chengdu exhibit favorable healthcare quality.Disparities exist among hospitals,necessitating lower-ranked hospitals to focus on internal management,improving service efficiency for high-quality development.

关 键 词：医疗服务 绩效评价 三级综合医院 CHS-DRG 成都 

分 类 号：R197.3[医药卫生—卫生事业管理]