基于DRGs的山东省公立医院住院服务绩效评价研究

Inpatient service performance evaluation of public hospitals in Shandong Province based on DRGs

目的应用疾病诊断相关组,对山东省公立医院住院服务能力、服务效率、服务质量三个维度,进行住院服务绩效评价研究。方法以北京版疾病诊断分组系统DRGs(BJ-DRGs)分组方式,以CMI、DRG组数及低风险组死亡率等5个指标对50家三级综合医院进行分析。结果对比分析相关指标,50家综合医院服务能力差距显著,医院治疗难度有待提高;服务效率集群现象明显;医院低风险组死亡率是0.0185%,具有一定的服务安全质量。结论利用DRG风险调整工具可以有效提高住院服务绩效评价的科学性和可靠性,能够体现同类医院相对技术水平和差异,仍需进一步提高病案质量,探索山东本土化评价模型,推进医院DRGs精细化管理。

Objective To apply the disease diagnosis related group to the performance evaluation of the inpatient service in Shandong public hospitals from the dimensions of inpatient service capacity, service efficiency and service quality. Methods According to the grouping method of Beijing version of the disease diagnosis grouping system DRGs(BJ-DRGs), 50 tertiary general hospitals were analyzed using 5 indicators such as CMI, the number of DRG groups and the mortality rate of the low-risk group. Results The comparative analysis of relevant indicators showed that the service capacity gap among the 50 general hospitals was significant, and the capacity of treatment needed to be improved;meanwhile, the clustering of service efficiency was obvious, and the mortality rate of the low-risk group was 0.0185%, which provided certain safety quality of service. Conclusions The use of DRG risk adjustment tools can effectively improve the scientificity and reliability of inpatient service performance evaluation, and can reflect the relative technical level and differences among similar hospitals. It is still necessary to further improve the quality of medical records, and explore the localized evaluation models of Shandong to promote the refined management of DRGs in hospitals.