摘要
目的以国家公立医院绩效考核指标体系为蓝本构建三级公立医院运营管理指标体系,并通过主客观相结合的方法确定各级指标权重,进而转化为评价天津市三级公立医院运营管理效果的政策工具。方法基于文献分析和专家咨询,初步筛选出23项指标,涵盖质量效率、社会效益、经济效益三个维度。采用聚类分析、变异系数法和因子分析联合筛选指标,最终保留11项核心指标。结合层次分析法和熵权法确定主客观权重,通过组合赋权法计算综合权重。结果构建的DRG绩效分配评价指标体系包括质量效率(出院人数、CMI、时间消耗指数等)和社会效益(成本率、百元耗材、药占比)和经济效益(住院执行收入、门诊执行收入、收支结余)三类指标。组合权重结果显示,经济效益和社会效益权重占比最高,质量效率次之。结论研究通过主客观结合的方法构建了科学、可操作的DRG绩效评价体系,为医院精细化管理和政策优化提供了理论依据。
Objective To construct an operational management indicator system for tertiary public hospitals based on the national performance evaluation framework for public hospitals,and to determine the weights of indicators at all levels through a combination of subjective and objective methods,thereby transforming it into a policy tool for evaluating the operational management effectiveness of tertiary public hospitals in our city.Methods Through literature analysis and expert consultation,23 preliminary indicators were selected,covering three dimensions:quality efficiency,social benefit,and economic benefit.Cluster analysis,coefficient of variation,and factor analysis were jointly applied to refine the indicators,retaining 11 core indicators.The subjective weights were determined using the Analytic Hierarchy Process(AHP),while objective weights were calculated via the Entropy Weight Method.A combined weighting approach was adopted to derive comprehensive weights.Results The constructed DRG(Diagnosis-Related Groups)performance allocation evaluation system included three categories:quality efficiency[number of discharged patients,Case Mix Index(CMI),time consumption index],social benefit(cost rate,material consumption per 100 yuan,drug proportion),and economic benefit(inpatient revenue,outpatient revenue,balance of payments).The combined weighting results revealed that economic benefit and social benefit held the highest weights,followed by quality efficiency.Conclusion This study established a scientific and actionable DRG performance evaluation system through a hybrid subjective-objective methodology,providing a theoretical foundation for refined hospital management and policy optimization.
作者
朱晓伟
马雷
杨蒙
林俊贤
ZHU Xiao-wei;MA Lei;YANG Meng;LIN Jun-xian(Dean's Office,Tianjin First Central Hospital,Tianjin 300000,China;Medical Insurance Department,Tianjin Cancer Hospital Airport Branch,Tianjin 300308,China;School of Government Management,Beijing Normal University,Beijing 100091,China)
出处
《继续医学教育》
2025年第7期178-182,共5页
Continuing Medical Education
基金
国家卫生健康委员会医院管理研究所(DSZ20251065)
天津市医院管理协会(2024zc137)。
关键词
DRG
绩效评价
指标体系
运营管理
天津
DRG
performance evaluation
indicator system
operation management
Tianjin
