[1]王娟 王兴武 张乐辉 李阳.通过DRGs优化手术分级和绩效评价[J].中国卫生质量管理,2019,26(05):057-59.[doi:10.13912/j.cnki.chqm.2019.26.5.17]
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通过DRGs优化手术分级和绩效评价
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《中国卫生质量管理》[ISSN:1006-7515/CN:CN 61-1283/R]

卷:
第26卷
期数:
2019年05期
页码:
057-59
栏目:
医疗质量
出版日期:
2019-09-28

文章信息/Info

作者:
王娟 王兴武 张乐辉 李阳
大同煤矿集团有限责任公司总医院
关键词:
诊断相关分组(DRGs)手术分级绩效评价
Keywords:
Diagnosis Related Groups (DRGs) Surgical Grading Performance Evaluation
DOI:
10.13912/j.cnki.chqm.2019.26.5.17
摘要:
目的探讨通过DRGs优化手术分级和手术绩效的可行性。方法采用百分位数法制定手术分级目录,并与临床专家制定的目录进行对比。基于某院2017年住院病案首页,利用CN-DRGs软件进行分组,对手术总权重校正后,用于某院手术科室绩效考核。结果以MDCG消化系统625条手术和操作为例,CN-DRGs法和专家法手术级别对比,完全一致的223条(占36%);较专家法级别高的221条(占35%);较专家法级别低的181条(占29%)。结论用手术总权重来代替手术例数,可以优化手术绩效,通过DRGs工具优化手术分级和手术绩效
Abstract:
ObjectiveTo explore the feasibility of improving surgical grading and performance evaluation by DRGs. MethodsThe percentile method was used to develop the catalogue of surgical grading, which was compared with the catalogue by clinical experts. Based on the data of DRGs from homepage of inpatients' medical records in 2017, the CN-DRGs software was used for grouping, and after correcting the total weight of surgery, it was used for the performance assessment of surgical department in a hospital. ResultsTaking 625 surgeries and operations of MDCG digestive system as an example, compared with CN-DRGs method and expert method, of which 223 (36%) were completely consistent. 221 (35%) were above the level of expert; 181 (29%) were lower than the level of expert.Conclusion The surgical performance can be optimized by replacing the number of surgical procedures with total surgical weight. It is feasible to optimize surgical grading and performance through DRGs.

参考文献/References:

[1]简伟研,胡牧,崔涛,等.运用疾病诊断相关组进行临床服务绩效评价初探[J].中华医院管理杂志,2006,22(11):736-739. [2]Lichtig L K.Hospital information system for case mix management[M].New York: John Wiley & Sons Press,1986. [3]邓小虹.北京DRGs系统的研究和应用[M].北京:北京大学医学出版社,2015:12. [4]邓小虹.CN-DRGs分组方案(2014版)[M].北京:中国医药科技出版社,2015:200-213. [5]Nathanson M.Comprehensive cost accounting systems give chains an edge[J].Modern Healthcare,1984,14(3):122-128. [6]周韵砚,江芹,张振忠.欧美国家DRG相对权重计算方法分析[J].中国卫生经济,2016,35 (5):94-96.

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更新日期/Last Update: 2019-09-28