基于DRGs的区域住院医疗服务绩效评价平台的构建与应用
2019-07-26
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doi:10.3969/j.issn. 1672-5166.2019.03.011

 

基于DRGs的区域住院医疗服务绩效评价平台的构建与应用

程兆辉 余中心 吴开明①△ 许小兰


阐述重庆市疾病诊断相关分组(DRGs)的住院医疗服务绩效评价平台构建,并应用该平台评价2015—2017年公立医院绩效。该平台基于国家DRGs质控中心版诊断相关分组(CN-DRGs)和北京版诊断相关分组BJ-DRGs)编码标准构建,涵盖病案质控、绩效评价、分析报告等模块。评价结果显示,3年间医院DRGs组数逐渐增多,病历组合指数(CMI)呈上升趋势,费用和时间消耗指数在三级综合医院和妇幼保健院呈下降趋势,在二级综合医院和中医综合医院呈上升趋势但有所波动,低风险组死亡率不断下降。未来应进一步提升病案质量、优化DRGs分组器、统一编码规则、加强结果应用,推进DRGs工作深入开展。

关键词 诊断相关分组 医疗服务 绩效评价 平台

 

Construction and Application of Regional Platform for Inpatient Medical Service Performance

Evaluation Based on DRGs

CHENG Zhaohui, YU Zhongxin, WU Kaiming, XU Xiaolan

Chongqing Health Information Center, Chongqing 401120, China

Abstract This paper has introduced the construction of inpatient medical service performance evaluation platform for Diagnosis Related Groups(DRGs) in Chongqing, and applies the platform to evaluate the performance of inpatient medical service in public hospitals during 2015~2017. The platform is based on National DRGs Quality Control Center Diagnosis Related Group (CN-DRGs) coding standard and the Beijing Diagnosis Related Group (BJ-DRGs) coding standards, covering medical records quality control, hospital performance evaluation, and analysis reports modules. Performance evaluation results showed that the number of DRG groups has gradually increased and the CMI value showed an overall upward trend in the 3 years. The cost and time consumption indexes showed a downward trend in tertiary general hospital and the maternal and child health care hospitals, and showed an upward trend but fluctuating in second-level general hospitals and traditional Chinese medicine general hospitals. The mortality rate of the low-risk group was decreasing. In the future, it should further improve the quality of hospital medical records, optimize DRG groupers, unify the coding rules, and strengthen the application of evaluation results to promote the in-depth development of Chongqing DRGs.

Keywords diagnosis related groups; medical service; performance evaluation; platform

 

基金项目:重庆市科卫联合医学科研项目面上项目(项目编号:2018MSXM108

重庆市卫生信息中心,重庆市,401120

作者简介:程兆辉(1989—),男,博士,统计师;研究方向:卫生政策,医院绩效;E-mail:czhbtx@163.com

通信作者:吴开明(1965—),男,硕士,高级经济师;研究方向:卫生信息化,医院管理;E-mail: wkm2006cq@126.com

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