基于疾病诊断相关分组的南宁市二级公立医院住院医疗服务绩效评价

Inpatient medical service performance evaluation of grade-Ⅱpublic hospital in Nanning based on diagnosis related groups

目的评价分析南宁市二级公立医院2019年的住院医疗服务情况。方法利用CN-DRGs分组器(2019版),从“能力”“效率”和“医疗安全”3个维度,采用描述性分析方法,从各指标的集中趋势、离散程度等方面进行住院医疗服务绩效的评价。结果2019年,受评的31家二级公立医院的诊疗范围覆盖746个疾病诊断相关分组(DRG),中位数为402组;病例组合指数(CMI)均值为0.70。综合绩效总分值位居前五名的医院是1、2、3、4及16号医院,其中4家为综合医院,1家为中医医院。综合绩效总分值最低者是24号医院,医院类别为民族医院。结论目前,南宁市二级公立医院住院医疗服务水平存在发展不平衡的现象。在下一步工作中应从政府和院方层面提升医疗服务能力,缩小区域间差距;加强医疗流程管控,提高医疗服务效率,为患者提供更优质的医疗服务。

Objective To evaluate and analyze the inpatient medical service of Nanning grade-Ⅱpublic hospital in 2019.Methods CN-DRGs Grouper(2019)was used to evaluate the performance of inpatient medical services from the three dimensions of“ability”“efficiency”and“medical security”,using descriptive analysis methods from the aspects of the concentration trend and dispersion degree of each indicator.Results In 2019,the 31 grade-Ⅱpublic hospitals covered 746 DRG groups,with a median of 402 groups.The mean CMI was 0.70.The top five hospitals with total score of comprehensive performance were No.1,No.2,No.3,No.4 and No.16 hospitals,of which 4 hospitals were general hospitals and 1 hospital was Chinese medicine hospital.No.24 hospital had the lowest total score of comprehensive performance which category was ethnic hospital.Conclusion At present,the inpatient medical service level of grade-Ⅱpublic hospitals in Nanning is unbalanced.In the next step,the medical service ability should be improved on the level of government and hospitals to narrow the gap between regions,strengthen the management and control of medical process,over the efficiency of medical services to provide better quality medical services.