基于DRGs绩效评价的DIP结算系数测算方法研究

Research on Calculation Method of DIP Settlement Coefficient Based on DRGs Performance Evaluation

目的为提高按病种分值付费(DIP)支付方式结算费用的科学性和精细程度,基于疾病诊断相关分组(DRGs)绩效评价研究DIP结算系数的测算方法,提出实施建议。方法选择DRGs绩效评价相关指标,使用成都市29家医院的DRGs绩效评价数据,运用因子分析法和综合指数法,测算各医院的结算系数。结果运用因子分析法和综合指数法测算的结算系数与临床实际相符合。结论基于DRGs绩效评价测算得到的结算系数,综合考虑了各医院的医疗服务质量、效率和安全因素,与其他制度配套使用,有利于促进统筹地区内各医院间的良性竞争和医保基金的高效分配。

Objective improve the scientific level and precision of diagnosis-Intervention Packet(DIP)payment,this study explored the accounting method of DIP settlement coefficient based on DiagnosticRelated Groups(DRGs)performance evaluation,and put forward some implementation suggestions.Method This study selected the relevant indicators of DRGs performance evaluation,used the data of 29hospitals in Chengdu,and calculated the settlement coefficient of each hospital by using factor analysis and comprehensive index method.Result The settlement coefficient calculated by factor analysis and comprehensive index method was consistent with clinical practice.Conclusion The settlement coefficient calculated based on DRGs performance evaluation takes into account the quality,efficiency and safety of medical services of each hospital,and is used in combination with other supporting systems,which is conducive to promoting the benign competition among hospitals within the overall planning area and the efficient allocation of medical insurance funds.