DRG用于医疗机构绩效分配模式研究——基于文献研究综述

A research on drg for performance distribution application mode in medical institutions-based on literature review

目的 全面分析梳理DRG在医疗机构绩效分配的主要模式和做法,为适应以按病种付费为主的多元复合式医保支付方式改革以及公立医院绩效分配改革提供参考。方法 系统检索中国知网关于DRG和医疗机构绩效分配、绩效考核等实证研究进行文献综述。结果 DRG在公立医院的运用主要包括工作量核算、全面质量考核,以及在数据来源、考核指标等进行了全面探讨分析。结论 适应DRG的绩效分配模式需要医疗机构做好前期准备工作,并充分考虑DRG用于不同科室的公平性、考核指标的设置以及指标及基础数据动态化等。

Objective To comprehensively analyze and sort out the main modes and practices of DRG for performance distribution in medical institutions,so as to provide reference for adapting to the reform of multiple compound medical insurance payment mode and the reform of performance distribution in public hospitals.Methods The empirical studies on DRG,performance distribution and performance appraisal of medical institutions were systematically searched and reviewed.Results The application of DRG in public hospitals mainly included workload accounting,total quality assessment and data sources,and assessment indicators were discussed and analyzed.Conclusion Medical institutions need to make preliminary preparations to get accustomed to DRG used for performance distribution and fully consider the fairness of DRG used in different departments,the setting of assessment indicators,and the dynamics of indicators and basic data.