基于DRG的医院床位效率分析及管理策略探讨

Efficiency analysis and management strategies of hospital beds based on diagnosis-related groups

目的:基于疾病诊断相关分组(DRG)指标改进床位效率评价方法,为医院合理配置床位、提高床位效率提供依据。方法:以北京地区某三级甲等医院为研究对象,以时间消耗指数为X轴、床位使用率为Y轴,绘制床位利用波士顿矩阵图,将科室床位分为效率型、压床型、周转型、闲置型;通过计算每床DRG权重,评价科室医疗服务效率和诊疗水平;改进理论床位数计算方法,将病例组合指数作为风险调整因素纳入公式,并评价床位配置状态。结合床位类型、每床DRG权重和床位配置状态,综合分析科室床位利用的改进重点和管理策略。结果:某院24个科室中,效率型、压床型、周转型、闲置型科室分别有5个、9个、1个、9个;11个科室的每床权重高于全院平均水平;床位数合适、偏少和偏多的科室分别有16个、5个和3个。结论:基于DRG综合分析床位利用类型、配置状态和每床权重,可有效地评价医院床位效率,从而为医院床位资源配置、医院运营重点调整和学科发展规划提供决策依据。

ObjectiveTo improve the evaluation method of hospital beds efficiency based on diagnosis-related groups(DRG),and to provide a basis for hospitals to allocate beds reasonably and improve bed efficiency.MethodsTaking a tertiary hospital in Beijing as the research object,the types of beds were evaluated by the beds utilization matrix with the time consumption index as the X-axis and the bed utilization rate as the Y-axis.The types of beds in the department were divided into efficiency type,pressure type,turnover type,and idle type.The efficiency of medical services and the level of diagnosis and treatment were evaluated by the weight of DRG per bed.The calculation method of theoretical number of beds was improved by incorporating hospital case mix index as a risk adjustment factor into the formula to evaluate the status of beds allocation.Combining the bed type,DRG weight per bed,and bed allocation status,the improvement emphasis and management strategy of bed utilization could be comprehensively analyzed.ResultsAmong the 24 departments in the hospital,there were 5,9,1 and 9 departments being efficiency type,pressure type,turnover type and idle type,respectively.The weight per bed of 11 departments was higher than the average level of the hospital.There were 16,5,and 3 departments with appropriate,fewer,and excessive beds,respectively.ConclusionsThe comprehensive analysis of beds utilization type,allocation status and weight of each bed based on DRG is an effective method to evaluate the efficiency of hospital beds,and can provide decision-making basis for hospital bed resource allocation,hospital operation focus adjustment,and subject development planning.