基于CMI和DRG组数的北京市二、三级综合医院感染性疾病服务能力量化分析  

Quantitative Analysis on Infectious Disease Service Capacity of Secondary and Tertiary General Hospitals in Beijing Based on CMI and Number of DRG Groups

作　　者：郝一炜 刘晓宇 陈吟 路凤 郭默宁 贾梦 Hao Yiwei;Liu Xiaoyu;Chen Yin;Guo Moning;Jia Meng(Beijing Ditan Hospital,Capital Medical University,Beijing,100015,China;不详)

机构地区：[1]首都医科大学附属北京地坛医院,北京100015 [2]首都经济贸易大学统计学院,北京100070 [3]北京市卫生健康大数据与政策研究中心,北京101117 [4]北京市医疗管理数据质量控制和改进中心,北京101117 [5]中国医学科学院医学信息研究所,北京100020

出　　处：《中国卫生经济》2024年第11期6-10,共5页Chinese Health Economics

基　　金：北京市医院管理中心“青苗”计划专项(QML20231806);首都医学发展科研基金(2021-1G-3051)。

摘　　要：目的:量化分析北京市二、三级综合医院感染性疾病科服务能力,提供北京地区感染性疾病科建设方面的客观数据支撑。方法:使用DRG工具界定感染性疾病范围,使用病例组合指数(CMI)和DRG组数刻画医疗机构服务能力,通过数据可视化和广义线性方程分析北京市67家二、三级综合医院感染性疾病服务能力在2016—2020年的差异性,选取代表性医院对不同级别医院的病种结构进行对比。结果:2016—2020年,三级综合医院CMI均在0.94~0.97区间波动,二级综合医院CMI均在0.70~0.72区间波动;2016—2019年,三级综合医院DRG组数均值在26.75~27.79区间波动,二级综合医院DRG组数均值在15.32~15.77区间波动,2020年,二、三级综合医院DRG组数均值均出现大幅下降。CMI和DRG组数两个指标均在医院级别层面差异有统计学意义(P<0.001),DRG组数指标在时间维度上差异有统计学意义(P<0.001)。结论:三级综合医院感染性疾病服务能力明显强于二级综合医院,大型三甲医院的感染性疾病医疗服务能力明显领先,二级综合医院整体服务水平偏低。应发挥头部三甲医院的优势打造感染性疾病科建设高地,结合医疗资源空间分布情况和需求特征有针对性提升二级综合医院感染性疾病服务能力。Objective:The service capacity of infectious diseases department in Beijing secondary and tertiary general hospitals was quantitatively analyzed to provide objective data support for the construction of infectious diseases department.Methods:The scope of infectious diseases was defined by the DRG tool,and the service capacity of medical institutions was described by the Case Mix Index(CMI)and number of DRG groups.The differences in the service capacity of infectious diseases in 67 secondary and tertiary general hospitals in Beijing from 2016 to 2020 were analyzed by data visualization and generalized linear equation,and the disease structure of different hospitals at different levels was compared by selecting representative hospitals.Results:From 2016 to 2020,the mean CMI of tertiary hospitals ranged from 0.94 to 0.97,while that of secondary hospitals ranged from 0.70 to 0.72.From 2016 to 2019,the average number of DRG groups in tertiary hospitals ranged from 26.75 to 27.79,and the average number of DRG groups in secondary hospitals ranged from 15.32 to 15.77,and the average number of DRG groups in secondary and tertiary hospitals showed a significant decline in 2020.CMI and number of DRG groups had statistical significant difference at hospital level(P<0.001),and number of DRG groups had statistical difference in time dimension(P<0.001).Conclusion:The infectious disease service capacity of tertiary general hospitals is obviously stronger than that of secondary general hospitals,and the infectious disease medical service capacity of large tertiary hospitals is obviously ahead,while the overall service level of secondary hospitals is low.We should give full play to the advantages of top three hospitals to build a high ground for infectious disease department construction,and combine the spatial distribution of medical resources and demand characteristics to improve the infectious disease service capacity of secondary hospitals.

关 键 词：感染性疾病 医疗服务能力 量化分析 北京 

分 类 号：R1-9[医药卫生—公共卫生与预防医学] R126.1