基于DRGs的四川省儿科医疗服务能力对比分析

Comparative Analysis of Pediatric Medical Service Capacity Based on DRGs in Sichuan Province

目的利用DRGs对四川省109家设有儿科服务的不同类别三级医疗机构医疗服务能力进行对比分析,为儿科医疗服务能力发展提供数据支撑。方法通过方差检验对四川省三级医疗机构儿科DRGs评价指标进行统计学分析;采用系统聚类分析方法对绩效评分结果进行分类,并以分类结果为因变量进行单因素方差分析。结果不同类型医疗机构DRGs组数、总权重、CMI值之间差异有统计学意义。将绩效评分结果聚类分成4组,处于一类组和二类组的均只有1家医院,都为专科医院。人员情况、医院经营状况和运行效率情况在不同聚类组别间差异有统计学意义。结论不同类型三级医疗机构儿科医疗服务能力水平差异较大,儿科医疗服务水平整体偏低。应多措并举,稳定医护人员队伍,引进临床亟需设备,建立儿科联合体,提升儿科医疗服务能力。

Objective To analyze the medical service capabilities of 109 different types of tertiary medical institutions with pediatric services by using the DRGs,to provide support for the development of pediatric medical service capabilities.Methods The evaluation indexes of pediatric DRGs in provincial tertiary medical institutions were statistically analyzed by analysis of variance test.The results of performance scoring were classified by cluster analysis,and the results were used as the dependent variable for one-way analysis of variance.Results There were statistically significant differences on the number of DRGs,total weight,and CMI among different types of medical institutions.The results of institutional performance scoring were clustered into four groups,and only one institution was in the first group and in the second group respectively which was specialist hospital.There were statistically significant differences among different cluster groups in personnel status,hospital operation status and operating efficiency.Conclusion The level of pediatric medical service in different types of tertiary medical institutions varied greatly,and the overall level of pediatric medical service was low.Multiple measures should be taken to stabilize the medical staff,introduce urgently needed clinical equipment,establish pediatric consortium,and improve pediatric medical service capacity.