采用DRGs进行临床医疗服务绩效评价对医学专业技术发展的影响

Influence on the Development of the Medical Professional Technology by Using DRGs to the Evaluation of Clinical Service Performance

目的探讨运用DRGs客观评价临床医疗服务绩效的医院管理新模式,对医学专业技术发展带来的影响。方法采集医院2015年和2016年病案首页数据,利用DRGs分组原理,引入DRGs系统评价平台,进行采用DRGs临床医疗服务绩效评价分析。结果比较2015年和2016年医院整体情况、单科室、各主诊组间和同学科间临床服务绩效评价,对比分析病例组合指数(CMI)、手术例数、三四级手术比例等指标变化情况,说明实行DRGs对医学专业技术发展产生的影响。与2015年相比,2016年DRGs组数略有增加,CMI从0.8586增加到0.9108,增幅6.08%;权重≥2的占比从3.76%增加到了4.32%;手术例数增加1466例,增长10.82%;三四级手术比例从40.91%增加到49.74%;低风险死亡率均为0.0000%。结论采用DRGs进行临床医疗服务绩效评价,关注收治患者的疾病技术难度,有利于推动医学专业技术发展,推动分级诊疗制度落实。

Objectives to explore the effect of the development of the medical professional technology by using DRGs to objectively evaluate the clinical service performance. Methods using grouping principle of the DRGs and the DRGs system evaluation platform, this paper conduct the evaluation and analysis of clinical service performance from the data of the hospital in 2015 and 2016. Results We compare the situation in 2015 and 2016 of the hospital, unit, among the attending between groups and the disciplines of clinical service performance evaluation, and analysis of the average CMI, operation number, The number of three and four operations to instructing influence on the development of medical professional and technical by using DRGs. Compared with 2015, the number of DRGs in 2016 increased slightly, and CMI increased from 0.8586 to 0.9108, increased up to 6.08%. The proportion of the weighted≥ 2 was increased from 3.76% to 4.32%. The number of surgical procedures rised by 1466, whichincreased 10.82 percent. The proportion of 3rd and 4th class surgical procedures increased from 40.91% to 49.74%; the hospital has a lowest risk of death（0.0000%）. Conclusion Using DRGs to improve the evaluation of clinical services performance,focusing on treating disease in patients with technical difficulties, is conducive to promote the development of medical professional and technology,and to push the grading system implement.