基于DRGs的综合性医院科室及专业组医疗服务绩效评价研究

Performance Evaluation of Medical Service in General Hospital Departments and Professional Groups based on DRGs

目的通过疾病诊断相关组对某综合性医院科室及专业组医疗服务进行绩效评价。方法本研究以DRGs住院医疗服务监测与分析系统和某区域疾病诊断相关分组医疗服务管理系统为研究平台,以在线上报的住院病案首页信息为基础,对某综合性医院2016年1月1日-2018年12月31日住院病例、DRGs组数、总权重和病例组合指数值等指标进行比较,从产能、效率和安全3个维度进行分析。结果2016年入组总病例数11338例,总入组率98.25%。2017年入组总病例数12077例,总入组率98.07%。2018年入组总病例数12393例,总入组率99.43%。2016年-2018年医院DRGs组数从376组提高到402组,总权重从8216上升到10413.52,CMI值由0.72上升到0.84,费用消耗指数从1降低到0.93,时间消耗指数从1.1降低到0.97,低风险死亡率从0.22降为0,中低风险死亡率从1.21降低到0.77。多数科室及专业组产能呈上升趋势、效率稳步提升、安全风险呈下降趋势。结论基于DRGs的科室及专业组医疗服务质量与绩效评价比传统评价方法更具有可比性和可操作性,可以帮助我们筛选出医疗安全风险案例,可以为医院绩效考核和医疗质量管理提供参考数据,有助于加强科室及专业组的内部管理,并为实现医院精细化管理和加强学科建设提供数据支撑。

Objective Through the disease diagnosis related group to a general hospital department and professional group medical service performance evaluation.Methods This study DRG hospitalization health service monitoring and analyzing system and Jiading area disease diagnosis related group medical service management system as the research platform,on the basis of the reported in hospital medical record home page information online,in a general hospital in January,12016 to December,312018 hospitalized patients with relevant into the number of cases,DRG group number,total weight and case mix index value indicators such as comparison,from the capacity,efficiency and safety of three dimensions were analyzed.Results In 2016,the total number of enrolled patients was 11,338,and the total enrollment rate was 98.25%.In 2017,the total number of enrolled patients was 12,077,and the total enrollment rate was 98.07%.In 2018,the total number of cases was 12,464,including 12,393 and 99.43%.From 2016 to 2018,the number of hospital DRGs groups increased from 376 to 402,the total weight increased from 8216 to 10413.52,the CMI value increased from 0.72 to 0.84,the cost consumption index decreased from 1 to 0.93,the time consumption index decreased from 1.1 to 0.97,the low risk mortality rate decreased from 0.22 to 0,and the low risk mortality rate decreased from 1.21 to 0.77.The productivity of most departments and professional groups is on the rise,the efficiency is rising steadily,and the safety risk is on the decline.Conclusions Based on DRGs department and professional medical service quality and the performance evaluation more comparable than traditional evaluation methods and operability,could help us to select medical security risk cases,could provide a reference for hospital performance evaluation and medical quality management data,help to strengthen the internal management departments and professional,and strengthen discipline construction and to realize the hospital of fine management to provide data support.