基于DRGs死亡风险分级在医疗质量评价中的应用

Application of Mortality Risk Classification for Medical Quality Evaluation Based on DRGs

目的基于疾病诊断相关组(Diagnosis Related Groups,DRGs)探讨死亡风险分级评价医院医疗质量的方法。方法以死亡风险分级方法评价医院整体医疗质量,进行科室间、专业间横向对比,并与总住院死亡指标进行比较。结果(1)总死亡率2015年0.137%低于2014年0.236%,低风险死亡率2015年0.008%高于2014年0,高风险死亡率2015年3.341%高于2014年1.773%;(2)非手术科室A和手术科室A在两类科室中总死亡率都是最高的,其中非手术科室A中高风险和高风险死亡率是最高的,而手术科室A仅中高风险死亡率是最高的;(3)MDCR专业组总死亡率为0.15%居第6位,低风险和中低风险死亡率分别为0.01%和0.24%。结论基于DRGs死亡风险分级是评价医院医疗质量的有效方法。

Objective To explore the method of mortality risk classification for medical quality evaluation based on DRGs.Method Morality risk classification method was applied to assess the overall hospital medical quality,horizontal comparison was done among departments,and they were compared with the assessment results from using the total hospital mortality.Results（1） 0.137% in 2015 was less than 0.236% in 2014 on total mortality rate.0.008% in 2015 was more than 0 in 2014 on low risk mortality.3.341% in 2015 was more than 1.773% in 2014 on high risk mortality.（2） Both non-surgical department A and surgical department A had the highest total mortality rate in departments of two types.And non-surgical department A had the highest medium-high risk mortality rate and high risk mortality rate,while surgical department A had the highest medium-high risk mortality rate.（3） The total mortality rate of MDCR professional groups was 0.15% ranking the sixth with low-risk and medium-low-risk mortality rate 0.01% and 0.24%respectively.Conclusion Mortality risk classification based on DRGs is an effective way to evaluate medical quality.