TOPSIS联合RSR综合评价法在CHS-DRG运营绩效体系建设中的应用研究  

Research on the Application of TOPSIS Combined with RSR Comprehensive Evaluation Method in the Construction of CHS-DRG Operational Performance System

作　　者：吕新兵[1] 孟丽萍 潘春华[1] 谢海梅[1] 申喜凤 耿晓坤[1] 吴英锋 Li Xinbing;Meng Liping;Pan Chunhua;Wu Yingfeng(Beijing Luhe Hospital,Capital Medical University,Beijing,101149,China;不详)

机构地区：[1]首都医科大学附属北京潞河医院,北京101149 [2]北京市朝阳区第三医院,北京100121

出　　处：《中国卫生经济》2024年第9期23-28,共6页Chinese Health Economics

基　　金：DRG驱动下价值医疗质量管理体系建设研究项目(YLZLXZ22K009);CHS-DRG付费下医疗质量负性影响因素分析及改进策略研究项目(YLZLXZ23G052)。

摘　　要：目的:探讨优劣解距离法(Technique for Order Preference by Similarity to Ideal Solution,TOPSIS)联合秩和比法(Rank Sum Ration,RSR)综合评价法,在建立国家医疗保障按疾病诊断相关分组(China Healthcare Security Diagnosis Related Groups,CHS-DRG)运营绩效体系中的作用.方法:应用SPSS PRO统计分析软件,采用TOPSIS每个月对医院CHS-DRG各病组按照病例组合指数(Case Mix Index,CMI)、总权重、每权重次均费用、每权重平均住院日、病组盈亏5项指标进行综合评价并排序,应用RSR法对TOPSIS病组排序结果进行分档,制定不同档次病组绩效奖励标准,将病组中每位患者奖励结果汇总还原到各临床科室,最终形成科室绩效奖励方案.观察医院医保患者相关运营关键指标变化,印证绩效奖励方案实施的效果.结果:经过TOPSIS联合RSR在CHS-DRG运营绩效体系建设中的应用,医院医保患者住院例数增加、CMI稳定、次均费用下降、平均住院日缩短、DRG病组盈余增加.结论:TOPSIS联合RSR综合评价法在CHS-DRG运营绩效体系建设中起到了良好的作用,作为医院经济运营评价的一种方法具有实用性和创新性.Objective:To explore the role of Technique for Order Preference by Similarity to Ideal Solution(TOPSIS)combined with Rank Sum Ration(RSR)comprehensive evaluation method in establishing the China Healthcare Security Diagnosis Related Groups(CHS-DRG)operational performance system under the CHS-DRG payment system.Methods:SPSSPRO statistical analysis software was used,and TOPSIS method was used to regularly evaluate and rank the CHS-DRG disease groups in the hospital based on five indicators:Case Mix Index(CMI),total weight,average cost per weight,average length of stay per weight,and group profit and loss.RSR method was used to classify the TOPSIS disease group ranking results,establish performance reward standards for different grades of disease groups,and summarize and restore the reward results for each patient in the disease group to each clinical department,ultimately forming a department performance reward plan.The changes in key operational indicators related to medical insurance patients in hospitals were observed to verify the effectiveness of implementing performance reward programs.Results:After the application of TOPSIS combined with RSR comprehensive evaluation method in the construction of CHS-DRG operational performance system,the number of hospital medical insurance patients were increased,CMI value were stabilized,average cost per visit were decreased,average length of stay were shortened,and DRG disease group surplus were increased.Conclusion:The TOPSIS combined with RSR comprehensive evaluation method has played a good role in the construction of the CHS-DRG operational performance system.As a method of hospital economic operation evaluation,it is practical and innovative.

关 键 词：优劣解距离法 秩和比法 国家医疗保障按疾病诊断相关分组 绩效体系 

分 类 号：R1-9[医药卫生—公共卫生与预防医学] F840.613[经济管理—保险]