基于DRG付费的天津市三级公立医院医疗服务绩效评价研究

Study on the evaluation of medical service performance in Tianjin tertiary public hospitals under DRG payment

目的评价基于DRG付费下天津市三级公立医院的医疗服务绩效,并探讨影响绩效的主要因素。方法采用熵权TOPSIS法和秩和比法相结合的评价方法,对天津市三级公立医院的医疗服务绩效进行评价。通过收集病例数、DRG组数、病例组合指数、总权重等指标数据,运用熵权TOPSIS法确定指标权重,利用秩和比法进行绩效评价和概率分析。结果指标权重排名前3位的分别是病例数17.944%、总权重12.796%、病例组合指数7.876%。医疗服务绩效排名前3位的医院为A11、A14、A12。从分档结果看,第1档包括A2、A17两家医院,占11.11%。结论DRG付费下天津市三级公立医院医疗服务绩效水平不一,存在明显差异。低绩效医院应加强内部管理,提升服务能力和效率,以达到高质量发展的目标。

Objective To evaluate the healthcare service performance of tertiary public hospitals in Tianjin under DRG payment and to explore the main factors affecting the performance.Methods The entropy weight TOPSIS method and Rank Sum Ratio(RSR)combined evaluation method were used to evaluate the healthcare service performance of tertiary public hospitals in Tianjin.By collecting data on indicators such as the number of cases,the number of DRG groups,the case-mix index,and the total weight,the entropy-weight TOPSIS method was used to determine the indicator weights,and then the RSR method was used to perform performance evaluation and probability analysis.Results The top 3 ranked index weights were number of cases 17.944%,total weight 12.796%,and case-mix index 7.876%.The top 3 ranked hospitals in ters of medical service performance were All,A14,and A12.From the results of grading,the first grade included two hospitals,A2 and A17,accounting for 11.11%,Conclusion There is a significant difference in the level of performance of medical services among tertiary public hospitals in Tianjin under DRG payment.Low-performing hospitals should strengthen their internal management and improve their service capacity and efficiency in order to achieve the goal of high-quality development.