摘要
目的通过构建疾病诊断相关分组(DRG)绩效管理指标体系,对2019年浙江省三级妇幼保健专科医院医疗服务绩效情况进行综合评价,分析杭州市某妇产科医院DRG绩效管理存在的问题。方法采用AHP层次分析法和熵权法组合权重,建立DRG绩效管理指标评价体系;利用灰色关联模型对全省15家三级妇幼保健专科医院医疗服务DRG绩效效果进行综合评价。结果在全省范围内杭州市某妇产科医院综合排名较高,CMI值评价得分较高,医疗服务诊治水平与能力较高;但住院患者住院费用、平均药费和耗材消耗高于其他医院,当日再入院率高于全省平均水平,影响了在全省范围内综合评价名次的提升。结论利用组合权重赋权建立指标评价体系,能够充分反映指标的重要程度和决策者的主观意愿,具有一定的科学性和适用性。建议调整住院费用结果、建立医疗成本监测、减少药品运营支出,以及对再入院率进行实时监测,杜绝分解住院次数,在保证疗效的前提下降低再入院率。
Objective To establish an index system with DRG performance management to comprehensively evaluate the medical service performance of tertiary maternity hospitals in Zhejiang Province in 2019, and to analyze the existing problems of DRG performance management in a maternity hospital.Methods An index evaluation system with DRG performance management was established by combining AHP and entropy weight method. A grey correlation model was used to comprehensively evaluate DRG performances of 15 tertiary maternity and child hospitals in the province.Results The maternity hospital in Hangzhou ranked high comprehensively in the province, the score of the CMI value was high, and the level and ability of diagnosis and treatment of medical services were high. However, the hospitalization cost, the average medicine cost, and the material consumption were higher than those in other hospitals, and the hospital readmission rate was higher than the average level of the entire province, which affected the promotion of its comprehensive evaluation in the whole province.Conclusion The establishment of the index evaluation system by using the combination weight can fully reflect the importance of the index and the subjective will of the decision-maker, and has certain scientificity and applicability. It is suggested to adjust hospitalization cost results, establish medical cost monitoring, reduce drug operating expenses, and conduct real-time monitoring of readmission rate, eliminate the decomposition of hospitalization times, and reduce readmission rate on the premise of ensuring efficacy.
作者
江圣洁
Jiang Shengjie(Department of Medical Administration,Hangzhou Obstetrics and Gynecology Hospital,Hangzhou 310008,China)
出处
《中国医院统计》
2021年第5期456-461,466,共7页
Chinese Journal of Hospital Statistics
基金
浙江省医院协会基金项目(2020ZHA-KEB320)。
关键词
妇幼保健机构
DRG绩效管理
组合权重
灰色关联
maternity and childcare institution
DRG performance management
combination weight
grey correlation
