成都市三级综合医院基于DRGs的住院医疗服务绩效评价

Evaluation of Hospitalization in Grade-Ⅲ General Hospitals in Chengdu Based on SC-DRGs

目的基于SC-DRGs对成都市29所三级综合医院2018年住院医疗服务进行绩效评价。方法利用四川省DRGs应用平台,从医疗服务能力、医疗服务效率、医疗质量与安全3个维度构建综合评价体系。结果 2018年,成都市三级综合医院共覆盖743个DRGs组,总权重为1 352 356.3,CMI均值为1.03;各医院医疗服务能力差异明显,DRGs组数多集中在500~700组,CMI指数主要分布于0.7~1.0;服务效率两极分化且普遍偏低,时间、费用消耗指数主要分布于第1、第3象限;部分医院医疗质量与安全水平偏低,19所医院中低风险组病死率低于平均水平(0.24‰),12所医院标准化病死率低于平均水平(7.36‰)。结论成都市三级综合医院应提升医疗服务能力,缩小内部差异,注重时间、费用双重管理,提高服务效率,加强临床路径管理,提高医疗质量与安全水平。

Objective Performance evaluation of Hospitalization Service in 29 Grade-Ⅲ General Hospital by SC-DRGs in 2018.Methods Using SC-DRGs application platform to build a comprehensive evaluation system from dimensions of medical service capability,medical service efficiency,medical quality and safety.Results In 2018,Grade-Ⅲ General Hospitals in Chengdu covered 743 DRGs groups,with a total RW of 1352356.3 and an average CMI of 1.03.The service capacity was obviously different among hospitals,the number of DRGs groups was mostly concentrated in 500-700,CMI index was mainly distributed in 0.7-1.0.The service efficiency was polarized and generally low.Time and cost con sumption indices were mostly distributed in the first and third quadrants.Some hospitals had low medical quality and safety levels.The mortality rates of the low-risk group in 19 hospitals were lower than the average(0.24‰),and the standardized mortality rates in 12 hospitals were lower than the average(7.36‰).Conclusion The grade-Ⅲ general hospitals in Chengdu should improve the medical service capacity,reduce internal differences,pay attention to dual management of time and cost,improve service efficiency,strengthen clinical path management,and improve medical quality and safety level.