DRGs视角下某医院医疗服务半径分析

Analysis of medical service radius of a hospital from the perspective of DRGs

目的通过分析某三甲医院的医疗服务半径及其变化趋势,为医院的科学发展规划提供决策依据。方法获取2016年至2019年的病案首页资料和DRGs运行指标,按患者现住址的行政区域统计分析各项业务指标的变化情况。结果医院各区域出院人次和DRGs组数均逐年增长,市本级患者构成比呈逐年下降趋势(χ趋势^2=441.74,P<0.001);区域CMI值表现为外市患者高于外县市高于市本级;MDCY(烧伤)、MDCN(女性生殖系统疾病及功能障碍)、MDCQ(血液、造血器官及免疫器官疾病和功能障碍)等MDC和整形烧伤科、神经外科、心胸外科等临床学科的区域辐射能力在增强。结论该院医疗服务辐射范围整体上有逐年扩张的趋势,未来需通过持续提升医疗质量和效率,积极推行分级诊疗,加强学科建设等措施,为本地市及周边区域的患者提供更加高质高效的医疗服务。

Objective To provide the decision-making basis for the scientific development planning of the hospital,by analyzing the medical service radius and its variation trend of a hospital.Methods The first page information of medical records and DRGs operation indicators from 2016 to 2019 were obtained,and the changes of various business indicators were statistically analyzed according to the administrative region of the patients′current address.Results The number of discharged patients and DRGs group in all regions of the hospital increased year by year,and the patient composition ratio at city level decreased year by year(χtrend^2=441.74,P<0.001).The CMI value was higher in patients from other cities than from local city.MDCY(burns),MDCN(diseases and dysfunction of the female reproductive system),MDCQ(diseases and dysfunction of the blood,hematopoietic and immune organs)and other MDC as well as orthopedics and traumatology,neurosurgery,and cardiothoracic surgery showed increased regional radiation capacity.Conclusion On the whole,the radiation scope of medical services in a hospital has been expanding year by year.In the future,measures such as continuous improvement of medical quality and efficiency,active implementation of graded diagnosis and treatment,and strengthening of discipline construction should be taken to provide more high-quality and efficient medical services for patients in the local city and surrounding area.