基于DRG质量绩效视角的县域医院协作成效评价体系构建及应用  

Construction and application of an evaluation system for collaboration effectiveness in county hospitals based on DRG quality performance

作　　者：江舜杰 韦聪 张茜玉 吴进 方玢茹 杨永挺[1] 朱利明[1] JIANG Shunjie;WEI Cong;ZHANG Qianyu;WU Jin;FANG Binru;YANG Yongting;ZHU Liming(Zhejiang Cancer Hospital,Hangzhou,Zhejiang Province,310022,PRC)

机构地区：[1]浙江省肿瘤医院,浙江省杭州市310022 [2]安徽医科大学卫生管理学院,安徽省合肥市230031 [3]温州医科大学医学人文与管理学院,浙江省温州市325035

出　　处：《中国医院》2025年第1期16-19,共4页Chinese Hospitals

基　　金：浙江省软科学研究计划项目(2024C35124);浙江省医药卫生科技计划项目(2025KY743);浙江省肿瘤医院软科学研究专项培育基金(SSR2022A1、SSR2022B2)。

摘　　要：目的:基于DRG质量绩效视角搭建县域医院协作成效评价指标体系,为评估协作成效提供科学依据。方法:应用文献研究、半结构访谈梳理形成初步指标池,再通过“德尔菲专家咨询-层次分析”方法确定评价指标体系和权重,采用加权TOPSIS进行实证案例分析。结果:两轮德尔菲专家咨询问卷有效回收率分别是94.74%和100%,权威系数为0.878,Kendall协调系数均在0~1,CR<0.1,指标通过一致性检验,最终构建了由3个维度18个指标的协作成效评价体系,维度层面“工作量”权重最大(50.682%),指标层面“出院人次”权重最大(12.903%),加权TOSIS结果显示近5年2023年医院质量绩效最好,协作成效开始显现。结论:基于质量绩效视角构建的协作成效评价体系具有科学性和可操作性,两院合作有成效。Objective:To develop an evaluation index system for collaboration effectiveness in county hospitals from the perspective of DRG(Diagnosis-Related Group)quality performance,providing a scientific basis for assessing collaboration outcomes.Methods:A preliminary index pool was established through literature review and semi-structured interviews.The Delphi method and analytic hierarchy process(AHP)were used to determine the evaluation index system and its weights.Weighted TOPSIS was applied for empirical case analysis.Results:The effective response rates for the two rounds of Delphi expert consultations were 94.74%and 100%,respectively,with an authority coefficient of 0.878.Kendall's coefficient of concordance ranged from 0 to 1,and the consistency ratio(CR)was less than 0.1,indicating that the indices passed the consistency test.A collaboration effectiveness evaluation system comprising 3 dimensions and 18 indicators was finalized.Among the dimensions,"workload"had the highest weight(50.682%),while"number of discharges"had the highest weight(12.903%)among the indicators.Weighted TOPSIS analysis revealed that the hospital's quality performance in 2023 was the best over the past five years,indicating emerging collaboration effectiveness.Conclusion:The collaboration effectiveness evaluation system constructed from a quality performance perspective is scientific and practical,demonstrating the effectiveness of inter-hospital collaboration.

关 键 词：县域医院 协作成效 DRG 质量绩效 指标体系 

分 类 号：R197.3[医药卫生—卫生事业管理]