TOPSIS法在基于疾病诊断相关组(DRGs)的医院绩效评价中的应用

Application of TOPSIS method in hospital performance evaluation based on disease diagnosis-related groups(DRGs)

目的探讨TOPSIS法在基于DRGs的医院绩效评价中的效果。方法收集2019年1~12月浙江省某三级甲等综合医院的出院患者病案首页信息,通过上海联众DRGs绩效考核系统运算,得出DRGs相关指标信息,运用TOPSIS评价法对院内各出院科室医疗服务进行综合绩效评价。结果DRGs组数为708组,占分组的85.7%;CMI为0.98,平均住院天数7.39 d,平均住院费用17862.52元;排名前5位的分别为重症医学科、心胸外科、急诊医学科、神经外科、感染病科,排名后5位的分别为介入医学科、眼科、整形外科、生殖内分泌科、产科。结论TOPSIS法能够集中地反应出各出院科室的优劣,更客观准确地反映不同类型科室的医疗服务、诊治范围、诊疗技术难度、服务效率等综合情况,较好地解决了不同科室间的医疗评价差别,为医院绩效管理、学科发展提供参考方向,值得应用推广。

Objective To investigate the effect of TOPSIS method in hospital performance evaluation based on DRGs.Methods From January to December 2019,the first-page information of discharged patients’medical records from a class A tertiary general hospital in Zhejiang province was calculated by Shanghai Unionnet DRGs performance evaluation system,and DRGs related index information was obtained.TOPSIS evaluation method was used to evaluate the comprehensive performance of medical services of various discharged departments in the hospital.Results The number of DRGs groups was 708,accounting for 85.7%of the groups.CMI was 0.98,the average length of hospitalization time was 7.39 days,and the average hospitalization cost was 17,862.52 yuan.The top five were departments of critical care medicine,cardiothoracic surgery,emergency medicine,neurosurgery and infectious diseases,while the bottom five were departments of interventional medicine,ophthalmology,plastic surgery,reproductive endocrinology and obstetrics.Conclusion TOPSIS method reflects the advantages and disadvantages of various discharged departments in a centralized way,more objectively and accurately reflects the comprehensive situation of medical service diagnosis and treatment scope,technical difficulty of diagnosis and treatment,service efficiency and so on of different types of departments,better solves the differences in medical evaluation between different departments,provides a reference direction for hospital performance management and discipline development,and is worthy of application and promotion.