临床医务人员对DRGs认知的调查分析

Investigation and Analysis of Clinicians' Cognition to DRGs

目的了解临床医务人员对疾病诊断相关分组(DRGs)认知的现状,为设计DRGs系列培训提供依据。方法对DRGs结余为负值的临床科室医生进行典型抽样问卷调查,应用方差分析对各类人群的DRGs认知情况进行统计分析。结果调查临床医生83名,98.8%听说过DRGs工具,其中仅13.3%的医生对DRGs工具熟悉或精通。基础知识、医保付费、首页填报及绩效考核4个维度的得分分别是3.17±1.12分、2.71±1.41分、2.81±1.32分和2.64±1.54分。方差分析发现不同工作年限在绩效考核维度的得分差异有统计学意义,不同科室在基础知识维度的得分差异有统计学意义。结论在DRGs技术的实施过程中仍需加强临床医生的认知培训,在培训设计时,对不同年资医生应各有所侧重。建议多科室联合,形成管理合力,协作推广DRGs;借助新媒体平台,拓宽培训半径,提升培训效率;重视前期宣传及后期数据总结反馈工作,持续优化培训品质。

Objective To investigate the current status of the cognition of Diagnosis Related Groups(DRGs) in physicians and to provide references for designing series training of DRGs.Methods Questionnaire survey was conducted in the clinical department which had negative balance of DRGs using representative sampling.One-way ANOVA was used to analyze the cognition among different groups of medical staffs.Results A total of 83 physicians were involved in our study.Among them,98.8% had heard of DRGs.However,only 13.3% of the physician reported they were familiar with or skilled in DRGs.The average scores of the four dimensions were 3.17±1.12 in basic knowledge,2.71±1.41 in medical insurance,2.81±1.32 in home page of medical records and 2.64±1.54 in performance evaluation,respectively.There was statistical difference in score of performance evaluation among different length of working years.We also observed statistical difference in score of basic knowledge among different departments.Conclusion It is necessary to strengthen the training of physicians in DRGs knowledge and tools.The content of training should depend on the working years of the physicians.Suggestion Multi-disciplinary team(MDT) in management was formed to collaborate in the promotion of DRGs.By using the new media platform,we can broaden the training scope and enhance the efficiency of training.By paying attention to the publicity work before training,data collection and feedback work after training,we can continuously increase the quality of training.