DRGs方法在临床亚专科医疗服务绩效评价中的应用

DRGs- based Clinical Service Performance Evaluation of Some Medical Sub Discipline

目的运用疾病诊断相关组指标对样本医院"消化系统大手术"亚专科住院医疗服务绩效进行评价,为医院加强精细化管理和学科建设提供数据支持。方法以"国家版诊断相关组"作为风险调整工具,从能力、效率和安全3个维度对样本医院"消化系统大手术"亚专科住院医疗服务绩效进行评价。结果 2008—2015年样本医院亚专科总权重逐年增加,2015年亚专科病例数占市属医院的50.27%;时间消耗指数0.91,但费用消耗较市属医院平均水平高24%;2015年GB15、GB25疾病组死亡率均为0,GB11、GB23疾病组死亡率低于市属医院平均水平。结论 2008—2015年样本医院"消化系统大手术"亚专科医疗服务能力稳步提升,在市属医院范围内具有明显优势;但须注意在保持服务效率和安全优势的同时,增加GB11、GB23疾病组病例的收治,并应注意严格控制患者住院费用。

Objective By using DRGs-related indicators,to evaluate its clinical service performance of the medical sub discipline ＂Major Operation of Digestive System Diseases＂ of a tumor hospital, and to provide data support for fine management and discipline construction. Methods Evaluating its clinical service performance of the sub disciplines by using the three dimension index of capacity,efficiency and safety according to CN-DRGs risk adjustment tool. Results From 2008 to 2015,the total weight value of the sub discipline of the tumor hospital increased year by year. In2015,the number of cases accounted for 50.27% of the entire municipal hospital. The time consumption index was0.91,but charge consumption index was 24%,which was higher than the average level of municipal hospitals. The mortality rate of disease group GB15 and GB25 was 0,and the mortality rate of GB11 and GB23 was lower than the average level of the municipal hospitals in 2015. Conclusion The capacity of the sub discipline of the tumor hospital increases steadily from 2008 to 2015,and has obvious advantages in this range of municipal hospitals. But the hospital must pay attention to increasing cases of disease group GB11,GB23,and controlling hospitalization expenses of patients strictly while maintaining the service efficiency and security advantages.