基于疾病诊断相关分组的医院科室床位效率分析及配置策略探讨

Efficiency analysis and allocation strategy discussion in hospital department beds from the perspective of diagnosis related groups

目的应用疾病诊断相关分组(DRG)作为风险调整工具,研究结合疾病复杂程度和治疗难度的床位利用效能评价方法,为床位优化配置提供决策依据。方法以某三级甲等医院2018年DRG运行数据为基础,以科室时间指数和病床利用率代表时间效率和负荷状态,绘制四象限分布图评价科室床位运行效率;以单床DRG权重评价科室床位产出效率。结果47个科室床位运行效率中,"低效高负荷"型、"高效高负荷"型、"高效低负荷"型、"低效低负荷"型分别有5、8、26、8个科室;从科室床位产出效率来看,25个科室的产出效率高于全院平均水平。结论基于DRG对大型医院科室床位规模绩效和运行效率进行综合评价,具备科学性、客观性,可用于指导床位资源合理配置。

Objective To study the bed utilization efficiency evaluation method combining the complexity of diseases and the difficulty of treatment by using diagnosis related groups(DRG)as a risk adjustment tool,so as to provide decision basis for the optimal allocation of beds.Methods Based on the DRG operation data of a tertiary first-class hospital in 2018,the time index and bed utilization rate of the department represented the time efficiency and load status,and the four-quadrant distribution map was drawn to evaluate the operating efficiency of the department bed.The output efficiency of department beds was evaluated by the single bed DRG weight.Results Among the 47 departments,there were 5,8,26 and 8 departments with"low efficiency and high load","high efficiency and high load","high efficiency and low load"and"low efficiency and low load"respectively;the output efficiency of 25 departments was higher than the average level of the whole hospital.Conclusions The comprehensive evaluation of bed size performance and operation efficiency in large hospitals based on DRG is scientific and objective,which can be used to guide the rational allocation of bed resources.