某三甲儿童医院DRG绩效综合评价分析

Comprehensive Evaluation and Analysis of DRG performance in a Third-Class Children’s Hospital

目的分析某儿童医院DRG医疗服务绩效评价,发现差距,为医院管理、学科建设和合理控制费用提供参考依据。方法选取某三甲儿童医院2015年1月1日-2019年12月31日期间住院病案首页信息,并经过某省医院质量管理与绩效评价平台DRG分组器分组,入组292 839例,以医院5年指标的平均值做为标杆值,计算DRG组数、DRG总量、CMI值、效率指数、基础费率和医疗安全指标得分值,计算综合得分,得分越高,评价越好。结果某院5年平均CMI值1.0310,平均DRG组数471组,平均DRG总量60539,DRG总量和组数逐年增加。2019年医院综合绩效总得分和服务能力得分最高,其中DRG总量和组数增加明显,显示医院医疗服务水平逐年提高。2016年服务效率和效率指数得分最低。2018年和2019年医院基础费率高于平均值。结论运用综合指数法对DRG多项指标进行综合评价,结果符合医院实际,对提高医院运营效率、学科建设和控制医疗费用有指导意义。

Objective The performance evaluation of DRG medical service in a children’s hospital is analyzed,and the gap is found,which provides a reference basis for hospital management,discipline construction and reasonable cost control.Methods The information on the first page of hospitalized medical records of a third-class children’s hospital from January 1,2015 to December 31,2019 was selected and grouped by the quality management and performance evaluation platform DRG of a provincial hospital.292839 cases were enrolled in the group.Taking the average of the hospital’s 5-year index as the benchmark value,the number of DRG groups,total DRG,CMI value,efficiency index,basic rate and medical safety index were calculated,and the comprehensive score was calculated.The higher the score,the better the evaluation.Results The 5-year average DRG value of a hospital was 1.0310,the average number of DRG groups was 471 groups,and the average total amount of DRG and the number of groups increased year by year.The 5-year average DRG value of a hospital was 1.0310,the average number of DRG groups was 471 groups,and the average total amount of DRG and the number of groups increased year by year.In 2019,the total score of comprehensive performance and service ability of the hospital were the highest,in which the total amount of DRG and the number of groups increased significantly,indicating that the medical service level of the hospital improved year by year.The score of service efficiency and efficiency index was the lowest in 2016.Hospital base rates are higher than average in 2018 and 2019.Conclusion The comprehensive index method is used to comprehensively evaluate many indexes of DRG.The results accord with the reality of the hospital and are of guiding significance for improving hospital operation efficiency,discipline construction and controlling medical expenses.