基于DRG相关指标的公立医院精细化管理

Fine Management of Public Hospitals based on DRG-related Indicators

目的探索通过基于DRG相关指标数据的临床科室和医师综合评价方法,为公立医院医师精细化管理提供数据支持。方法通过DRG相关指标数据,从工作数量和质量2个维度,使用出院患者数量、住院病种数量、住院术种数量、CMI、DRG组数、时间消耗指数、费用消耗指数、低风险死亡率8个指标,采用工作数量×工作质量计算综合得分,对科室及医师进行评价,根据评价结果对临床科室和医师进行分组分层管理。结果科室综合得分最高2.81分,最低0.09分,按科室综合得分将全院科室分为甲、乙、丙、丁四组,各组内科室个数分别为4个、6个、11个、7个。四组分别随机选取一个科室进行医师评价,分别为科室E1、X、R、L,样本科室各级别医师评价结果为主任医师分别为1名、2名、2名、0名;主治医师得分范围分别为0.47~4.34、1.06~1.17、0.45~2.63、0.44~1.35;住院医师得分范围分别为0.74~2.79、0.28~2.36、0.87~2.23、0.14~2.13,各科室组样本科室数据结果各不相同,各级别医师分布情况各具特点。结论利用DRG相关指标数据对临床科室和医师进行综合评价,根据结果对科室和医师进行分组分层管理,评价标准相对统一、结果相对客观,在一定程度上完善了医师评价机制,为助力医院精细化管理、激活医院高质量发展新动力提供了数据支持。

Objectives This study aims to explore the comprehensive evaluation method of clinical departments and physicians based on DRG-related index data and to provide data support for the fine management of physicians in public hospitals.Methods Through DRG-related index data,the departments and physicians were evaluated from the two dimensions of work quantity and quality using the eight indices of the number of discharged patients,number of inpatient diseases,number of inpatient procedures,CMI,number of DRG groups,time consumption index,cost consumption index,and low-risk mortality.The composite score was calculated by the number of jobs combined with the quality of jobs.the clinical departments and physicians were grouped and stratified according to the evaluation results.Results The highest department comprehensive score was 2.81,and the lowest was 0.09.According to the department comprehensive score,the whole hospital was divided into A,B,C,and D groups,and the number of departments in each group was 4,6,11,and 7,respectively.One department from the four groups was randomly selected for physician evaluation,which was departments E1,X,R,and L.The evaluation results of physicians at all levels in the sample departments were 1,2,2,and 0 chief physicians,respectively.The scores of attending physicians ranged from 0.47 to 4.34,1.06 to 1.17,0.45 to 2.63,and 0.44 to 1.35,respectively.The scores of resident physicians ranged from 0.74 to 2.79,0.28 to 2.36,0.87 to 2.23,and 0.14 to 2.13,respectively.The data results of sample departments of each department group were different,and the distribution of physicians at all levels had their own characteristics.Conclusions Using DRG-related index data to conduct a comprehensive evaluation of clinical departments and physicians and conducting group and hierarchical management of departments and physicians according to the results gave relatively uniform evaluation criteria and relatively objective results.To a certain extent,the doctor evaluation mechanism has been improved,and data support has been provided to help the hospital's refined management and activate the new impetus for the hospital's high-quality development.