目的评估在医保支付方式改革实施后,浙江省按疾病诊断相关分组(diagnosis related groups,DRG)付费模式对全省二、三级综合医院住院患者平均医疗负担变化的影响,为继续扩大推动DRG付费政策提供有效的数据支持。方法以浙江省医院质量管...目的评估在医保支付方式改革实施后,浙江省按疾病诊断相关分组(diagnosis related groups,DRG)付费模式对全省二、三级综合医院住院患者平均医疗负担变化的影响,为继续扩大推动DRG付费政策提供有效的数据支持。方法以浙江省医院质量管理与绩效评价平台提供2019—2022年浙江省二、三级医院DRG质量绩效分析报告为依据,使用Microsoft Excel建立数据库,并采用描述性统计方法,对DRG付费政策实施前后住院患者医疗负担的变化进行对比与分析。结果在DRG付费模式下,各等级医疗机构住院患者平均住院天数下降明显;除温州市以外的10个地区及省级医院,经病例组合指数(case mix index,CMI)校正后的住院患者平均费用下降明显。结论DRG付费模式的应用,促进医疗机构主动从粗放型管理向精细化转变,主动顺应DRG付费改革机制,通过调整与规范自身诊疗行为,强化临床路径等管理工具的应用,达到降低住院患者医疗负担目的,从而提高医保基金的使用效率,降低医保基金存在穿底的风险。展开更多
Malcolm Baldrige National Quality Award-BNQA-SA was introduced in 1987 in US companies to create overall excellence in all parts of an organisation, leading to “integrated companies” as the ultimate goal for sustain...Malcolm Baldrige National Quality Award-BNQA-SA was introduced in 1987 in US companies to create overall excellence in all parts of an organisation, leading to “integrated companies” as the ultimate goal for sustained performance by using the Baldrige Excellence Framework (BEF). The “Balanced Score Cards” (BSC) methodology, as an instrument of designing, cascading and communicating strategy, was introduced in 1992. Operations excellence is an outcome of a well-designed, monitored and implemented operations strategy (OS). This paper traces the evolution of an “OS Wheel” model of operations strategy, for continuous manufacturing industries (CMI), deployed using the BEF, using BSC’s, to achieve performance excellence and sustained competitive advantage. The model was applied in a large scale, CMI company in India, over a period of fifteen years (a longitudinal study), the description of which will demonstrate its utility.展开更多
文摘Malcolm Baldrige National Quality Award-BNQA-SA was introduced in 1987 in US companies to create overall excellence in all parts of an organisation, leading to “integrated companies” as the ultimate goal for sustained performance by using the Baldrige Excellence Framework (BEF). The “Balanced Score Cards” (BSC) methodology, as an instrument of designing, cascading and communicating strategy, was introduced in 1992. Operations excellence is an outcome of a well-designed, monitored and implemented operations strategy (OS). This paper traces the evolution of an “OS Wheel” model of operations strategy, for continuous manufacturing industries (CMI), deployed using the BEF, using BSC’s, to achieve performance excellence and sustained competitive advantage. The model was applied in a large scale, CMI company in India, over a period of fifteen years (a longitudinal study), the description of which will demonstrate its utility.
