DRGs背景下基于改良德尔菲法的精神专科医院医疗绩效评价指标体系构建研究  

Construction of a DRGs-based medical performance evaluation index system in psychiatric hospitals using a modified Delphi method

作　　者：潘轶竹[1] 郭默宁 蒋锋[3] 李晓虹 王明刚[5] 肖存利 Pan Yizhu;Guo Moning;Jiang Feng;Li Xiaohong;Wang Minggang;Xiao Cunli(Beijing Anding Hospital,Capital Medical University,Beijing 100088,China;Beijing Municipal Health Big Data and Policy Research Center;Shanghai Jiao Tong University;Beijing Huilongguan Hospital;Beijing Chaoyang Hospital of Capital Medical University;Beijing Xicheng District Ping'an Hospital)

机构地区：[1]首都医科大学附属北京安定医院,北京100088 [2]北京市卫生健康大数据与政策研究中心 [3]上海交通大学 [4]北京回龙观医院 [5]首都医科大学附属北京朝阳医院 [6]北京市西城区平安医院

出　　处：《中国医疗管理科学》2024年第1期105-111,共7页Chinese Journal Of Medical Management Sciences

基　　金：北京市医院管理中心“培育计划”管理项目(PG2021033)。

摘　　要：目的遴选目前疾病诊断相关分组(Diagnosis Related Groups,DRGs)背景下的精神专科医院的绩效评价指标,初步构建评价指标体系,为精神专科医院医疗绩效评价指标体系建立提供建议和参考。方法基于国家及北京市属医院绩效考核指标体系,结合现有DRGs评价指标,确定评价指标,运用改良德尔菲法进行两轮专家咨询,结合精神专科医院患者及诊疗服务特点,对现有绩效评价指标体系进行调整,建立适用于精神专科医院医疗绩效评价的指标体系。结果两轮专家积极程度均为100%、专家权威程度分别为0.78和0.82、Kendall’s W协调系数分别为0.16和0.27,两轮Cronbach’sα系数均大于0.8,最终形成的指标体系包含3个一级指标、48个二级指标。结论本研究构建的精神专科医院绩效评价指标体系,通过增加“短住院(<60天)平均住院日”“短住院(<60天)人数占比”等适用性指标,删减不适用指标,可以更客观地评价不同级别精神专科医院的医疗绩效情况,为提升精神专科医院医疗服务质量提供参考依据。Objective To preliminarily construct a performance evaluation system tailored to psychiatric hospitals within the context of Diagnosis Related Groups(DRGs).Methods Based on the national hospital performance evaluation index system and those developed by Beijing municipal hospitals and by referring to the DRGs evaluation index,the evaluation indicators were selected.After two rounds of Delphi expert consultation,in combination with the patient and medical service characteristics of the psychiatric hospitals,the existing systems were adjusted to generate a new performance evaluation index system suitable for psychiatric hospitals.Results The positive coefficients of experts were 100%in the first and second rounds,and the authority coefficients were 0.78 and 0.82,respectively.The Kendall's coefficients of concordance(W)were 0.16 and 0.27,respectively.Cronbach'sαcoefficients were greater than 0.8 in both rounds.The final index system consisted of three first-level indicators and 48 second-level indicators.Conclusions By adding applicability indicators such as"average length of stay for short hospitalization(<60 days)"and"proportion of short hospitalization(<60 days)"and omitting the non-applicable indicators,the new index system enables more objective evaluation of medical performance and facilitates the improvement of medical service quality in psychiatric hospitals.

关 键 词：德尔菲法 DRGS 精神专科医院 绩效评价 指标体系 

分 类 号：R197.5[医药卫生—卫生事业管理]