医院DRG运营管理体系设计与应用研究

Research on design and application of the DRG operation management system in hospitals

目的:通过医院DRG运营管理体系的建设,解决DRG数据利用效率不高、运营指标不统一、缺乏可视化分析等问题,为医院运营管理状态的监测、分析、评价、预测提供应用支撑。方法:本研究从医院运营实践出发,介绍了医院DRG运营管理体系的建设过程,包括DRG模型和DRG运营分析功能的设计,并研究了DRG运营管理系统的医保控费、临床路径管理、医疗服务绩效评价3大应用场景。结果:DRG应用于医院运营管理,提升了DRG数字化运营水平和医疗服务质量,实现了医疗费用的合理管控。结论:在满足国家、省、市三级DRG管理体系建设要求的基础上,医院DRG运营管理模式可更好地服务于医院的科学运营管理。

Objective Through the construction of the DRG operation management system of the hospital,to solve the problems such as inefficient of DRG data utilization,non-uniform of operation indicators,and lack of visual analysis,and provide application support for the monitoring,analysis,evaluation and prediction of the operation management status of the hospital.Methods From the hospital operation practice,this study introduced the construction process of the DRG operation management system of hospital,including the design of DRG model and DRG operation analysis function,and dissected three application scenarios of the system to cost control of medical insurance,clinical path management and medical service performance evaluation.Results The application of DRG in hospital operation management improved the digital operation level of DRG and the quality of medical services,and realized the reasonable control of medical expenses.Conclusion On the basis of meeting the requirements of national,provincial and municipal DRG management systems construction,the DRG operation and management mode can serve the scientific operation and management of the hospital better.