基于熵权法的DIP付费下指标体系构建及综合评价

Research on the Construction and Comprehensive Evaluation of Index System under DIP Payment based on Entropy Weight Method

目的:构建某三甲医院按病种分值付费(DIP)下的指标体系,对临床科室进行综合评价,探索DIP付费下临床科室的绩效评价,为公立医院适应DIP支付方式改革提供实践经验及建议。方法:通过专题小组讨论及熵权法确立DIP付费下指标体系,以内科科室为例对其进行综合评价。结果:指标权重排序从高到低为:总量指数(27.6%)、CMI(22.4%)、每床日指数(19.2%)、每指数单价(10.3%)、每指数耗材单价(7.8%)、每指数药品单价(7.5%)、入组率(5.2%);综合评价前三位的科室为心血管内科、肿瘤介入科、神经内科。结论:基于熵权法设置的指标权重较为合理,构建DIP付费下的指标体系对临床科室进行综合评价,能客观科学地反映各专科医疗服务工作及诊治水平,并支撑医院对各临床科室之间的绩效评价。

Purpose:To construct an indicator system under the disease-based payment(DIP)of a certain grade A tertiary hospital,conduct a comprehensive evaluation of clinical departments,explore the performance evaluation under the DIP indicator system,and provide practical experience and suggestions for public hospitals to adapt to the reform of DIP payment methods.Methods:The DIP evaluation index system was established through focus group discussions and entropy weight method,and a comprehensive evaluation was conducted taking the internal medicine department as an example.Results:The ranking of DIP indicator weights from high to low is:total volume index(27.6%),CMI(22.4%),daily index per bed(19.2%),unit price per index(10.3%),unit price of consumables per index(7.8%),unit price of each index drug(7.5%),enrollment rate(5.2%);the top three departments in the comprehensive evalua-tion are cardiovascular medicine,interventional oncology,and neurology.Conclusion:The DIP indicator weight set based on the entro-py weight method is relatively reasonable.Constructing an indicator system under DIP payment to comprehensively evaluate clinical de-partments can objectively and scientifically reflect the medical service work and diagnosis and treatment levels of each specialty,and support the hospital’sevaluation of each clinical department.performance evaluation.