DRG指标在医院绩效考核体系中的应用与思考——基于浙江省38家医院的调研分析

Application and Reflection on the DRG-related Indicators in Hospital Performance Management System——Based on the Survey and Analysis of 38 Hospitals in Zhejiang Province

目的:分析浙江省内医院绩效考核体系与DRG支付方式改革结合的现状与方法。方法:选择浙江省内38家医院作为调研访谈对象,了解医院在绩效考核体系中与DRG支付方式改革结合的方法以及具体使用指标等。结果:53%的调研医院在绩效考核体系的科室单项奖考核部分纳入了DRG相关指标,包括医院医保基金超支金额、CMI值等。结论:目前医院的绩效考核体系侧重DRG费用管理评价,对于医疗服务能力和医疗效率的评价较少,未来可进一步利用DRG指标进行多维评价,同时结合过程管理应对DRG支付方式改革。

Objective:This paper analyzes the current situation and methods of combining hospital performance evaluation system with DRG payment method reform in Zhejiang Province. Methods: Through research and interviews with 38 hospitals in Zhejiang Province, we learned whether and what DRG-related indicators were used in hospital performance evaluation. Results: 53% of the surveyed hospitals included DRG-related indicators into the department individual award evaluation part of the performance evaluation system, including the overexpenditure amount of hospital medical insurance fund, CMI value, etc. Conclusion: At present, the hospital performance evaluation system focuses more on DRG cost management than evaluation of medical service capacity and medical efficiency. In the future, DRG-related indicators can be used for multi-dimensional evaluation, and hospitals can adapt to the reform of DRG payment with process management.