基于DRGs的高值耗材监控预警体系的构建及应用

Construction and application of high value consumables monitoring and early warning system based on DRGS

目的基于疾病诊断相关分类DRGs绩效评价系统(以下简称DRGs系统)构建高值耗材监控预警体系。方法利用DRGs系统中某三甲妇产专科医院妇科肿瘤科高值耗材使用数据,从监控类高值耗材占比和监控类高值耗材标化均值两个维度对监控类高值耗材使用的合理性进行预警。结果通过监控类高值耗材占比和监控类高值耗材标化均值的协同预警,将不合理用耗的风险范围定位缩小至不同手术级别的各诊疗组。结论基于DRGs系统构建高值耗材监控预警体系,对高值耗材使用的精细化管理及医疗服务质量的提升具有一定的参考价值。

Objective To Build a High Value Consumable Monitoring and Warning System Based on the DRGs Performance Evaluation System for Disease Diagnosis Related Classifications(hereinafter referred to as the DRGs System).Methods Using the data on the use of high-value consumables in the Gynecology and Oncology Department of a tertiary obstetrics and gynecology specialized hospital in the DRGs system,this study provides early warnings on the rationality of the use of monitoring type high-value consumables from two dimensions:the proportion of monitoring type high-value consumables and the standardized mean of monitoring type high value consumables.Results By collaborative warning of the proportion of monitoring high value consumables and the standardized mean of monitoring high value consumables,the risk range of unreasonable consumption is narrowed down to various diagnostic and treatment groups at different surgical levels.Conclusion Building a monitoring and warning system for high-value consumables based on DRGs system has certain reference value for the refined management of high-value consumables usage and the improvement of medical service quality.