基于C-DRG收付费模式下医疗质量及服务效果评价分析

Evaluation and Analysis of Medical Quality and Service Effect Based on C-DRG Collection and Payment Mode

目的 分析C-DRG收付费改革对福建省某三甲医院的医疗质量及服务效果进行评价分析,为改善医疗服务和精细化管理提供方向。方法 从服务能力、服务效率、质量安全和费用管理四个维度对医院2019年1月—2020年12月相关数据进行统计分析。结果 医院在实施DRG付费改革后DRG入组率、CMI值、总权重总体上保持平稳,平均住院时间缩短,时间消耗指数、费用消耗指数、低风险组死亡率下降,药品占比、检查、检验占降低,医疗服务性收入占比提高,住院收入中来自医保基金的比例增加。结论 基于C-DRG数据指标对医疗质量及服务效果进行评价分析,可为持续改善医疗服务和精细化管理提供数据支持。

Objective To analyze the C-DRG payment reform and evaluate and analyze the medical quality and service effect of a third class hospital in Fujian Province, and to provide direction for improving medical services and fine management. Methods The relevant data in January 2019 to December 2020 were statistically analyzed from four dimensions of service capacity, service efficiency, qualitysafety and cost management. Results After the implementation of DRG payment reform,the DRG enrollment rate, CMI value and total weight remained stable, the average length of stay was shortened, the time consumption index, cost consumption index and mortality rate of low-risk group were decreased,The proportion of drugs, examinations and tests decreased, the proportion of medical service income increased, and the proportion of hospitalization income from the medical insurance fund increased. Conclusion The evaluation and analysis of hospital medical quality and service effect based on C-DRG data index can provide data support for continuous improvement of medical service and fine management.