基于DRGs的公立医院绩效评价研究

Research on Performance Evaluation of Public Hospitals Based on DRGs

目的以住院患者的就诊数据为基础,对我院实施DRGs改革的结果进行预判,探索DRGs在医院绩效改革中的应用。方法从我院的HIS系统中抽取2018年全年的住院患者的信息,根据DRG对病案信息的要求,对提取信息进行清洗和筛选。采用DRG《2016版CN-DRGs分组方案》对患者信息进行分组,采用总权重指数、病例组合指数CMI等指标评价医院各科室的服务能力及服务效率。建立绩效考核的模型,对我院各科室的医疗服务进行评价。结果我院各科室出院患者覆盖了746个《2016版CN-DRGs分组方案》中的疾病组,覆盖程度高;医疗服务的总权重值为41340.6563,CMI值为0.81893,费用消耗指数为1.11064,时间消耗指数为0.99385。结论我院信息化建设程度可以适应DRGs改革的要求,住院患者保持较高的入组率。DRGs可以客观评价我院的医疗服务能力、医疗服务效率等,基于DRG的绩效评价可以真实反映我院各科室的实际情况。

Objective Based on the medical data of inpatients,predict the results of the DRGs reform implemented in our hospital,and explore the application of DRGs in the hospital performance reform.Methods The information of hospitalized patients throughout 2018 was extracted from the HIS system of our hospital,and the extracted information was cleaned and screened according to the requirements of DRG for medical record information.The DRG"2016 CN-DRGs Grouping Plan"was used to group patient information,and indicators such as the total weight index and the case mix index CMI were used to evaluate the service capabilities and service efficiency of each department in the hospital.Establishing a performance appraisal model to evaluate the medical services of various departments in our hospital.Results Discharged patients from various departments in our hospital covered 746 disease groups in the"2016 CN-DRGs Grouping Plan",with a high degree of coverage;the total weight value of medical services was 41340.6563,the CMI value was 0.81893,and the cost consumption index was 1.11064.The consumption index was 0.99385.Conclusion The degree of informatization construction in our hospital could meet the requirements of DRGs reform,and inpatients maintain a high enrollment rate.DRGs could objectively evaluate the medical service capacity and efficiency of our hospital,and performance evaluation based on DRG could truly reflect the actual situation of our hospital's departments.