DRGs在某三甲医院外科中心绩效评价中的应用

Application of DRGs in Performance Evaluation of A Surgical Center in the Tertiary Hospital

目的探索疾病诊断相关组(DRGs)评价指标在某三甲医院外科中心医疗绩效评价体系中的应用。方法提取该院外科中心2018年1月-12月出院病案首页,通过“BJ-DRGs”分组器对之自动化分组,从医疗服务的“能力”“效率”和“医疗安全”等方面进行绩效评价。结果该中心收治疾病大类(MDC)组数为18组,DRGs组数为95组,病例组合指数(CMI)为0.697,处于全院较低水平;时间消耗指数、费用消耗指数均接近1,处于全院平均水平。治疗疾病范围最广的是A病区,DRGs组数为68组;C病区技术难度最高,CMI指数为0.718;A病区住院时间消耗最短,费用消耗最低,效率分数为1.305。TOPSIS综合评价显示,A病区绩效最优,C1医师绩效最优。结论DRGs评价指标既能够评价科室综合服务能力、服务效率和服务质量,又能够针对不同级别的医师进行综合评价。

Objective To explore the application of Diagnosis Related Groups(DRGs)evaluation index in the medical performance evaluation system of a surgical center in the tertiary hospital.Methods The first page of medical records from the surgical center discharged from January to December 2018 was extracted,and its automatic grouping was carried out by"BJ-DRGs"grouper.The performance of a surgical center was evaluated in terms of"ability","efficiency"and"medical safety",etc.Results There were 18 groups of major diseases categories(MDC),95 groups of DRGs and case-mix index(CMI)of 0.697 in the center,which were at the lower level of the whole hospital.Time consumption index and cost consumption index were close to 1,which were at the average level of the whole hospital.The most widely treated diseases was the A ward with 68 DRGs,the C ward with the highest technical difficulty with a CMI of 0.718,and the A ward with the shortest hospitalization time,the lowest cost and the efficiency score of 1.305.TOPSIS comprehensive evaluation showed that the performance of the A ward was the best,and that of physician of the C1 was the best.Conclusion DRGs evaluation index can not only evaluate the comprehensive service ability,service efficiency and service quality of departments,but also comprehensive evaluation for different levels of doctors.