基于DRGs的医院住院医疗服务绩效评价与应用

Performance Evaluation and Application of Hospital Inpatient Medical Services Based on DRGs

目的运用(疾病)诊断相关分类(diagnosis related groups,DRGs)研究评价某二级甲等医院发展态势及临床科室综合发展能力。方法回顾分析2017-2018年的DRGs指标,纵向比较两年来该医院医疗服务能力,利用综合指数法比较该医院与北京市二级综合医院医疗服务能力、效率、安全,以及综合得分情况。结果2018年收治病例数周期增幅为3.31%,疾病覆盖范围略有下降;医疗服务总产出上涨4.48%,收治病例严重程度有所上升,但各临床科室的综合得分普遍低于北京市二级综合医院平均水平,主要受分析病例数多寡的影响,导致医疗服务能力得分普遍偏低,且医疗服务效率欠佳。结论该医院正处于发展上升期,但整体而言与北京市二级综合医院平均水平存在差距,医疗服务广度不足,资源利用效率不高,临床专科间的发展差距较大,应注重学科均衡发展,扬长避短,努力提升服务能力与效率,增强综合能力。

Objective Using DRGs to evaluate the development trend of the hospital and the comprehensive capability of clinical departments.Methods Review and analyze the DRGs indicators from 2017 to 2018,and compare the medical service capabilities of the hospital in the two years,using the comprehensive index to compare the medical service capacity,efficiency,safety and comprehensive scores of the hospital and Beijing secondary general hospitals.Results The number of patients treated in 2018 increased by 3.31%,disease coverage has declined slightly;the total output of medical services rose by 4.48%,and the severity of medical cases has increased.However,the overall score of each clinical department is generally lower than the average level of Beijing's secondary general hospitals,mainly affected by the number of cases analyzed,resulting in a generally low score of medical service ability,and medical services are not efficient.Conclusion Overall,the hospital is on the rise of development,and there is a gap compared with the average level of the secondary general hospitals in Beijing.The insufficient breadth of medical services and resource utilization,the large development gaps between clinical specialties.The hospital should pay attention to the balanced development of disciplines,foster strengths and avoid weaknesses,strive to improve service capabilities and efficiency,and enhance comprehensive capabilities.