基于德尔菲法的DRG付费实施效果评价指标体系构建研究

Research on constructing an evaluation index system for the implementation effect of DRG payment based on Delphi method

目的构建DRG付费实施效果评价指标体系,对DRG支付方式改革实施效果进行有效评价。方法通过文献研究和专家讨论初步构建评价指标体系,采用德尔菲法进行两轮专家咨询,采用权重法确定各指标权重。结果两轮专家咨询问卷回收率分别为100.00%、95.20%,专家的权威系数为0.92,最终构建了以医疗机构、医保部门、医保患者3个维度多层次的DRG付费实施效果评价指标体系,共包含3项一级指标、13项二级指标、50项三级指标。结论参与研究的专家具有较好的代表性、学术权威性,且关注度和积极性高,表明研究构建的DRG付费实施效果评价指标体系具有科学性、系统性和可操作性,但需在实际工作中进一步验证。

Objective To establish an indicator system for evaluating the implementation effectiveness of Diagnosis Related Groups(DRG)payment,and to effectively evaluate the effects of the DRG payment reform.Methods Through literature research and expert discussions,a preliminary evaluation indicator system was constructed.Two rounds of expert consultations were conducted using the Delphi method,and the weight method was used to determine the weight of each indicator.Results The response rates of the two Delphi consultations were 100.00% and 95.20%,respectively,and the authority coefficient of the experts was 0.92.Finally,a multi-level evaluation indicator system for the implementation effectiveness of DRG payment was established,including four dimensions:medical institutions,medical insurance departments,medical insurance patients,and overall evaluation,with a total of four primary indicators,11 secondary indicators,and 50 tertiary indicators.Conclusion The experts involved in the study were representative,academically authoritative,and highly attentive and proactive,indicating that the DRG payment implementation effectiveness evaluation indicator system constructed in the study is scientific,systematic,and operable,but further verification is needed in practical work.