摘要
目的:基于高质量发展背景下医院提质增效需求,评价和分析广州市某三甲医院住院服务绩效,为医院精细化管理和资源配置优化提供参考。方法:构建包含DRG指标的投入产出集合和基于投入松弛测量度的超效率数据包络分析模型,使用Helmsman方法纳入质量维度,并进行投影分析、效率分解与规模报酬分析。结果:科室运行效率、绩效均值分别为0.43、0.46,绩效高效科室仅6个且有13个低效科室需改进质量。呼吸内科、心血管内一科在质量调整后产出评价下降。低效科室中5个科室需优先调整规模,15个科室应重视提升技术水平。需改进质量的低效科室中3个科室纯技术效率值变动大于规模效率值变动,10个科室纯技术效率值变动小于规模效率值变动。结论:样本医院总体住院服务绩效处于较低水平,不同科室绩效、质量水平及改进方向存在差异,呼吸内科、心血管内一科应作为质量改进重点关注科室。应用结合Helmsman方法的DRG-DEA方法可对住院服务绩效进行评价与改进分析。医院应对科室实施差异化管理,关注医疗质量所需技术与规模,结合现实情况与管理方法工具改进住院服务绩效。
Objective:To evaluate and analyze the inpatient service performance of a tertiary hospital in Guangzhou,based on the need of hospital to improve quality and efficiency under the background of high-quality development,and to provide reference for hospital delicacy management and resource allocation optimization.Methods:The input-output set was constructed,incorporating the DRG index and the super-efficiency data envelopment analysis model based on the input slacks measure.The Helmsman method employed to integrate the quality dimension,while projection analysis,efficiency decomposition,and return to scale analysis were conducted.Results:The mean values of department operation efficiency and performance were 0.43 and 0.46 respectively.There were only 6 departments with high performance and 13 departments with low efficiency that need to improve their quality.The output of department of respiratory medicine and division I of cardiovascular medicine department decreased after quality adjustment.5 of the inefficient departments should be given priority to adjust their scale,and the remaining 15 departments should pay attention to improving their technical level.Among the inefficient departments that need to improve quality,the change of pure technical efficiency value of 3 departments was greater than that of scale efficiency value,and the change of pure technical efficiency value of 10 departments was less than that of scale efficiency value.Conclusion:The overall inpatient service performance level of the sample hospital was low,and there were differences in the performance,quality level and improvement direction of different departments.The department of respiratory medicine and division I of cardiovascular medicine department should be the focus of quality improvement.The DRG-DEA method combined with Helmsman method can be used to evaluate and improve the performance of inpatient services in departments.The hospital should implement differentiated management of departments,pay attention to the technology and scale
作者
杨博文
翁开源
李云晓
张芳
YANG bowen(School of Medical Business,Guangdong Pharmaceutical University,Guangzhou,Guangdong,510000,China)
出处
《医学与社会》
北大核心
2024年第3期137-144,共8页
Medicine and Society
基金
国家自然科学基金资助项目,编号为91956113
广东省教育厅2022年普通高校教育重点科研平台项目,编号为2022WCXTD011
广东省哲学社会科学规划项目,编号为GD21SQGLO1。
关键词
医院管理
住院服务
绩效
科室
DRG
Hospital Management
Inpatient Service
Performance
Department
DRG
