[1]莫陶欣 王丹 杨煦 冷家骅 刘晶 薛冬.基于DRGs肿瘤专科医院精细化管理探讨[J].中国卫生质量管理,2018,25(02):016-19.[doi:10.13912/j.cnki.chqm.2018.25.2.05]
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基于DRGs肿瘤专科医院精细化管理探讨
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《中国卫生质量管理》[ISSN:1006-7515/CN:CN 61-1283/R]

卷:
第25卷
期数:
2018年02期
页码:
016-19
栏目:
特别关注
出版日期:
2018-03-28

文章信息/Info

作者:
莫陶欣 王丹 杨煦 冷家骅 刘晶 薛冬
北京大学肿瘤医院
关键词:
疾病诊断相关分组精细化管理肿瘤专科医院
Keywords:
DRGs Delicacy Management Cancer Hospital
DOI:
10.13912/j.cnki.chqm.2018.25.2.05
摘要:
目的探讨疾病诊断相关组(Diagnosis Related Groups,DRGs)在肿瘤专科医院精细化管理中的实践经验。方法以某肿瘤专科医院为例,采用了2016年上半年(26 879例)和2017年上半年(30 155例)纳入DRGs分组的出院病例,运用DRGs评价体系,从产能、效率、安全3个维度,以医院、病组、科室、人员等不同层面对医院运行情况进行评价。结果(1)2017年上半年,全院收治患者的DRGs组数是247例,CMI指数0.94;时间消耗指数0.53,费用消耗指数0.92,低风险死亡率0.02%,中低风险死亡率0.06%;较2016年同期,全院收治患者的能力有所提升,效率更高,但安全性并未降低。(2)通过综合评分对全院科室进行排名,手术科室S1总体得分(5.61)在全院排第一,其次是非手术科室F1(得分4.72)。DRGs指标和评分的高低与科室特点有关。(3)对某科室医师a、b进行评价,医师a的CMI值(1.23)高于医师b(2.70),综合得分差异有统计学意义(a医师7.08,b医师4.94)。DRGs评价结果公平性较强。结论DRGs评价体系是实现肿瘤专科医院精细化管理的有效途径。
Abstract:
ObjectiveTo investigate the practice experience of delicacy management in cancer hospital under the guidance of diagnosis related groups (DRGs).MethodsThe data of inpatients with DRGs in the first half year in 2016 (26 879) and the first half year in 2017 (30 155) in a cancer hospital were included. DRGs evaluation system was used to evaluate hospital running conditions including hospital, departments and personnel from three dimensions of production capacity, efficiency and safety.Results(1) The number of patients admitted to the hospital in DRGs group was 247, CMI index was 0.94; time consumption index was 0.53, cost consumption index was 0.92; low-risk mortality was 0.02%, medium-low-risk mortality was 0.06%. Compared to the same period in 2016, the capacity of patients admitted to the hospital and efficiency had improved, and safety had not reduced. (2) All departments of the hospital were ranked by the comprehensive scores. The surgical department S1 ranked the highest score of 5.61, followed by the non-surgical department F1 of 4.72. DRGs indicators and the level of the score had relationship with departmental characteristics. (3) Using DRGs to evaluate and compare doctor A and doctor B, A got a lower CMI index of 1.23 than that of B of 2.70, and the general score had statistically significance (7.08 for A and 4.94 for B). DRGs evaluation result was fair. Conclusion DRGs evaluation system is an effective approach to realize delicacy management in tumor hospital.

参考文献/References:

[1]Inke Mathauer and Friedrich Wittenbecher. DRG-based payment systems in low- and middle-income countries: Implementation experiences and challenges[R].World Health Organization, 2012.

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更新日期/Last Update: 2018-03-28