基于诊断相关组和模糊物元法对某三级甲等医院骨科系统住院医疗服务绩效的评价

Evaluation of Inpatient Medical Services Performance of Orthopedic System in a Tertiary First-class Hospital Based on DRGs and Fuzzy Matter-element Method

目的:通过诊断相关组(DRGs)和模糊物元法对某三级甲等医院骨科系统15个科室的2016年住院医疗服务绩效进行评价分析,为优化医院资源配置和促进医疗服务精细化管理提供参考。方法:采用DRGs和模糊物元法对15个科室的住院医疗服务绩效进行综合评价,建立涵盖3个标准层(安全指标、医疗能力和工作效率),8个指标[医院感染发生率、治疗中并发症发生率、非计划二次手术率、DRGs分组数、病例数、病例组合指数(CMI)、时间消耗指数和费用消耗指数]的某三级甲等医院住院医疗服务的绩效评价指标体系。结果:D15、D10、D9科室的欧式贴近度排名前三,依次为0.411、0.348、0.326,其住院医疗服务质量最优;D6和D8科室的欧式贴近度最低,分别为-0.326、-0.204,其住院医疗服务质量有待提高。结论:基于DRGs法的模糊物元法使用简单、快捷有效,能够客观、准确地反映某三级甲等医院骨科系统各科室医疗服务工作的优势和短板。

Objective：To assess and analyze inpatient medical services performance at the year of 2016 in 15 departments of orthopedic departments in a tertiary first-class hospital based on diagnosis related groups（DRGs） and fuzzy matter-element method, therefore, to provide the reference for optimizing the allocation of resources and promoting meticulous management of medical service. Methods：DRGs and fuzzy matter-element method were used to evaluate inpatient medical services performance in 15 departments generally, to establish performance evaluation index system of inpatients medical services in a tertiary first-class hospital which contained three standard floors（safety index, medical ability and work efficiency）, and eight indexes（nosocomial infection incidence, the incidence of the complications during the treatment, unplanned secondary surgery rate, the grouping numbers of DRGs, the number of medical cases, case mix index（CMI）, time consumption index and cost cunsumption index）. Results：D15, D10 and D9 departments ranked in the first three in euclid approach degree, they were 0.411, 0.348 and 0.326,and the quality of inpatient medical services was the best; D6 and D8 departments were in the lowest of euclid approach degree, they were-0.326 and-0.204 respectively, and the quality of inpatients medical services needed to be improved. Conclusion：On the foundation of DRGs, fuzzy matter-element method is simple, rapid and effective, it could reflect the advantages and disadvantages of medical services in different departments of orthopedic system in a tertiary first-class hospital accurately and objectively.