加权TOPSIS法在临床科室DRGs指标综合评价中的应用

Application of weighted TOPSIS Method to evaluate the Comprehensive Efficiency of DRGs-related Indexes in Clinical Departments

目的探讨TOPSIS法在临床科室DRGs指标综合评价中的应用,为医院的精细化管理提供参考。方法以某院2019年1月1日-2019年12月31日住院病案首页数据为基础,运用BJ-DRGs分组工具对住院病例进行分组。采用加权TOPSIS法,从住院医疗服务能力、效率和安全3个维度,纳入了CMI值、DRGs组数、床均权重值、时间消耗指数、费用消耗指数和低中风险死亡率共6个指标对各临床科室的DRGs指标进行综合评价。结果综合评价排名前3位是科室B、D、E,排名后3位是科室P、J、Q。科室B床位产出效率最高,科室L、M、N住院医疗服务效率较高,医院住院医疗服务安全水平整体较好。结论科室B需适当加强疑难病症的收治能力,扩大疾病收治的覆盖范围。科室Q需要提高住院医疗服务效率,缩短住院时间,降低医疗费用。TOPSIS法和DRGs指标能客观评价住院医疗服务水平,有助于医院和科室精细化管理。

Objectives To explore the application of the TOPSIS method in the comprehensive evaluation of DRGs-related indexes in clinical departments, and provide references for the hospital’s refined management.Methods Based on the information of the front pages of medical records of the hospital from January 1 st, 2019 to December 31 st, 2019, the BJ-DRGs grouping tool was used to group inpatient medical records. The weighted TOPSIS method was used to comprehensively evaluate the DRGs-related indexes of each clinical department from the three dimensions of inpatient medical service capacity, efficiency and safety. Results The top three in the comprehensive evaluation were departments B,D and E. The bottom three were departments P, J, and Q.Department B had the highest output efficiency. Departments L, M, and N had higher inpatient medical service efficiency, and the overall hospital inpatient medical service was at a high safety level. Conclusions Department B needed to appropriately strengthen the treatment capacity of intractable diseases and expand the coverage of disease admissions. Department Q needed to improve the efficiency of inpatient medical services, shorten the length of stay,and reduce medical expenses. The TOPSIS method and DRGs indicators could objectively evaluate the level of inpatient medical service, which was helpful for the refined management of the hospital and departments.