应用DRGs模型构建医院手术分级评价体系的研究  

Study on the Application of DRGs Model to Construct the Grading Evaluation System of Hospital Surgery

作　　者：宁蕾 常起 NING Lei;CHANG Qi(Department of Medical Service,the Second Affiliated Hospital of Shandong First Medical University,Tai'an Shandong 271000,China;Personnel Division,the Second Affiliated Hospital of Shandong First Medical University,Tai'an Shandong 271000,China)

机构地区：[1]山东第一医科大学第二附属医院医务处,山东泰安271000 [2]山东第一医科大学第二附属医院人事科,山东泰安271000

出　　处：《中国卫生标准管理》2024年第7期55-58,共4页China Health Standard Management

基　　金：山东省医药卫生科技发展计划项目(202215020748)。

摘　　要：目的探讨以诊断相关分组(diagnosis related groups,DRGs)模型为基础构建医院手术分级评价体系的相关经验,并报告其结果。方法随机抽取2022年1月—2023年6月山东第一医科大学第二附属医院外科系统,通过统一的绩效考核平台提取的住院病案首页相关数据进行分析。针对医院手术分级评价体系,观察组构建DRGs模型,对照组采取常规手术分级评价体系。比较2组手术权重及患者次均权重占比,2组平均住院天数及平均住院费用比较,统计2组三四级手术占比、月手术量情况,分析2组并发症发生率、28d再入院及疾病痊愈率。结果观察组手术权重及患者次均权重占比均高于对照组(P<0.05)。观察组患者平均住院天数短于对照组(P<0.05),患者平均住院费用低于对照组(P<0.05)。观察组三四级手术占比高于对照组,月手术量多于对照组,外科系统平均绩效高于对照组(P<0.05)。观察组发生并发症和28 d再入院的比例分别为2.9%、1.1%,低于对照组的11.6%、4.3%(P<0.05),疾病痊愈率为96.7%,高于对照组的86.2%(P<0.05)。结论以DRGs模型为基础进行医院手术分级评价系统构建,可显著提高医务人员劳动积极性,提高劳动报酬,缩短住院时间,降低住院费用,对降低外科手术并发症发生率和28 d再入院率,提高疾病治愈率有积极意义。Objective To explore the related experience of constructing the grading evaluation system of hospital surgery based on DRGs model,and report the results.Methods The department of surgical,the Second Affiliated Hospital of Shandong First Medical University from January 2022 to June 2023 was randomly selected,and the related data of the first page of inpatient medical records extracted by a unified performance appraisal platform were analyzed.In view of the grading evaluation system of hospital surgery,the observation group built a DRGs model,while the control group adopted the grading evaluation system of routine surgery.The operation weight and the average weight ratio of patients,the average hospitalization days and the average hospitalization expenses of the two groups were compared,and the proportion of third-and fourth-grade operations and the monthly operation volume of the two groups were counted,and the complications,28 days readmission and disease recovery rate of the two groups were analyzed.Results The proportion of operation weight and patients'average weight in the observation group was higher than that in the control group(P<0.05).The average hospitalization days of patients in the observation group were shorter than that in the control group,the average hospitalization expenses of patients were lower than that in the control group(P<0.05).The proportion of third and fourth level surgeries in the observation group was higher than that in the control group,and the monthly surgical volume was more than that in the control group.The average performance of the surgical system was higher than that in the control group(P<0.05).The incidence of complications and 28 days readmission in the observation group were 2.9% and 1.1%,respectively,lower than the control group's 11.6% and 4.3%(P<0.05),and the disease recovery rate was 96.7%,higher than the control group's 86.2%(P<0.05).Conclusion The construction of grading evaluation system of hospital surgery based on DRGs model can significantly improve the labor e

关 键 词：DRGs模型 医院 手术分级 评价体系 绩效分配 手术权重 

分 类 号：R197[医药卫生—卫生事业管理]