摘要
目的 验证临床路径实施水平与疾病诊断相关分组(DRG)支付方式改革落实之间是否存在协同作用,为公立医院高质量发展提供参考。方法 采用CRITIC权重法结合TOPSIS法评价临床科室临床路径和DRG的运行效果,再基于评价结果运用灰色关联度法测算临床路径总体及各监测指标与DRG评价结果的灰色关联度及其排名。结果 各临床科室临床路径管理与DRG运行效果的TOPSIS评价结果均具有一定的差异;临床路径管理与DRG实施效果间的总体关联度为0.848,与DRG支付方式改革实施效果关联度最大的临床路径监测指标为完成率(0.882),关联度最小的为执行入径人数的比例(0.704)。结论 各临床科室推行临床路径管理与DRG的效果存在一定差异;临床路径管理与DRG间具有较强的协同关系,医疗机构应针对性地完善临床路径管理,使临床路径成为推动DRG在临床上有效实施的重要工具。
Objective To verify whether there is synergy between the implementation level of clinical pathway and the implementation of DRG payment method reform,and to provide references for the high-quality development of public hospitals. Methods The CRITIC weighting method combined with the TOPSIS method was used to evaluate the clinical department’s clinical pathway and the operation effect of DRG, and then based on the evaluation results,the grey correlation method was used to calculate the grey correlation degree and ranking of the overall clinical pathway and each monitoring index and the DRG evaluation results. Results The TOPSIS evaluation results of clinical pathway management and DRG operation effect in each clinical department had certain differences;the overall correlation between clinical pathway management and DRG implementation effect was 0.848, and the clinical pathway monitoring index with the greatest correlation with the implementation effect of DRG payment method reform. It is the completion rate(0.882),and the smallest correlation is the proportion of the number of people performing the entry(0.704). Conclusion There is a certain difference in the effect of clinical pathway management and DRG implementation in each clinical department;there is a strong synergistic relationship between clinical pathway management and DRG,and medical institutions should improve clinical pathway management in a targeted manner,so that clinical pathway can promote the effective implementation of DRG in clinical practice important tool.
作者
田帝
周典
周苑
汪恒
接纯纯
杨琰
刘瑶瑶
张羽翔
吴烨
白忠良
Tian Di;Zhou Dian;Zhou Yuan(The Frist Affiliated Hospital of Anhui Medical University,Hefei,Anhui,230022,China;不详)
出处
《中国医院管理》
北大核心
2022年第10期13-17,共5页
Chinese Hospital Management
基金
安徽医科大学医院管理研究所“国医科技”开放项目(2022gykj06)
安徽省社会科学创新发展研究课题(2020CX107)
安徽省卫生健康软科学研究项目(2020WR02011)
安徽省卫生健康委科研项目(AHW2021a022)
合肥市软科学研究项目(2021017)
安徽医科大学校科研基金项目(2021xkj294)
合肥市医疗卫生“借转补”研发项目(J2020Y04)。
