目的探讨疾病诊断相关组(Diagnosis Related Groups,DRGs)在研究型医院绩效考核中的应用。方法运用申康版DRGs分组器,对比分析2015年上半年与2016年上半年研究型医院部分科室的出院例数、DRGs总权重数以及病例组合指数CMI(case mix ind...目的探讨疾病诊断相关组(Diagnosis Related Groups,DRGs)在研究型医院绩效考核中的应用。方法运用申康版DRGs分组器,对比分析2015年上半年与2016年上半年研究型医院部分科室的出院例数、DRGs总权重数以及病例组合指数CMI(case mix index)值。结果调查结果显示2015、2016年上半年出院例数最高的科室均为F科室(1012例)、C科室(856例)和E科室(832例),且2015、2016年上半年总权重数均为E科室最高,I科室最低,2015、2016年上半年CMI值最高的科室均为I科室。结论 DRGs系统在医院绩效考核中取得较好的效果,能够指导医务工作者合理利用医疗资源,提高服务效率,具有推广应用的价值。展开更多
目的首次应用诊断相关组（diagnosis related groups，DRGs）对北京市属医院系统整体进行主要诊断类别（major diagnosti ccategory，MIX；）住院服务绩效综合评价，并就评价结果提出加强北京市属医院系统主要疾病诊疗能力建设和提高住...目的首次应用诊断相关组（diagnosis related groups，DRGs）对北京市属医院系统整体进行主要诊断类别（major diagnosti ccategory，MIX；）住院服务绩效综合评价，并就评价结果提出加强北京市属医院系统主要疾病诊疗能力建设和提高住院服务绩效等方面的建议。方法应用BJ-DRGs分组器软件对2012年至2014年北京市全部出院病例病案首页信息进行计算确定各DRG组权重，并以全市各DRG组权重为基础，对2012年至2014年市属医院系统和央属医院系统的有关指标数据进行比较和分析。结果北京市属医院系统整体50％MDC的诊疗难度、81．8％MDC的时间效率、77．3％MIX；的费用效率、54．5％MDC的综合能力等指标上均有改善，且有68．2％MDC在费用效率、59．1％MDC在时间效率等指标上好于央属医院系统，但72．7N的MDC在诊疗难度上低于央属医院系统，综合能力指数2个系统相比持平；另发现3年来北京地区主要三级医院覆盖的疾病种类增加不明显。MDC权重中贡献率较大的市属医院与国家临床重点专科建设项目承接医院高度吻合。结论基于DRGs的北京市属医院系统整体主要疾病住院服务绩效综合评价结果显示，北京市医院管理局通过加大政府投入、优化服务组织、实施绩效管理等措施，对改善市属医院系统整体住院服务绩效尤其是在减轻患者负担、提高服务效率等方面发挥了重要作用，但也提示要通过集团化建设与管理等措施不断提高市属医院系统的临床专科能力，提高IVIDC诊疗难度，回归三级医院职能。展开更多
Background： With the rising incidence as well as the medical expenditure among patients with unstable angina pectoris, the research aimed to investigate the inpatient medical expenditure through the combination of di...Background： With the rising incidence as well as the medical expenditure among patients with unstable angina pectoris, the research aimed to investigate the inpatient medical expenditure through the combination of diagnosis-related groups （DRGs） among patients with nnstable angina pectoris in a Grade A tertiary hospital to conduct the referential standards of medical costs for the diagnosis. Methods： Single-factor analysis and multiple linear stepwise regression method were used to investigate 3933 cases between 2014 and 2016 in Beijing Hospital （China） whose main diagnosis was defined as unstable angina pectoris to determine the main factors influencing the inpatient medical expenditure,and decision tree method was adopted to establish the model of DRGs grouping combinations. Results： The major influential factors of inpatient medical expenditure included age, operative method, therapeutic effects as well as comorbidity and complications （CCs） of the disease, and the 3933 cases were divided into ten DRGs by four factors： age, CCs, therapeutic effects, and the type of surgery with corresponding inpatient medical expenditure standards setup. Data of nonparametric test on medical costs among different groups were all significant （P 〈 0.001, by Kruskal-Wallis test）, with R2 = 0.53 and coefficient of variation （CV） 0.524. Conclusions： The classification of DRGs by adopting the type of surgery as the main branch node to develop cost control standards in inpatient treatment of unstable angina pectoris is conducive in standardizing the diagnosis and treatment behaviors of the hospital and reducing economic burdens among patients.展开更多
文摘目的首次应用诊断相关组（diagnosis related groups，DRGs）对北京市属医院系统整体进行主要诊断类别（major diagnosti ccategory，MIX；）住院服务绩效综合评价，并就评价结果提出加强北京市属医院系统主要疾病诊疗能力建设和提高住院服务绩效等方面的建议。方法应用BJ-DRGs分组器软件对2012年至2014年北京市全部出院病例病案首页信息进行计算确定各DRG组权重，并以全市各DRG组权重为基础，对2012年至2014年市属医院系统和央属医院系统的有关指标数据进行比较和分析。结果北京市属医院系统整体50％MDC的诊疗难度、81．8％MDC的时间效率、77．3％MIX；的费用效率、54．5％MDC的综合能力等指标上均有改善，且有68．2％MDC在费用效率、59．1％MDC在时间效率等指标上好于央属医院系统，但72．7N的MDC在诊疗难度上低于央属医院系统，综合能力指数2个系统相比持平；另发现3年来北京地区主要三级医院覆盖的疾病种类增加不明显。MDC权重中贡献率较大的市属医院与国家临床重点专科建设项目承接医院高度吻合。结论基于DRGs的北京市属医院系统整体主要疾病住院服务绩效综合评价结果显示，北京市医院管理局通过加大政府投入、优化服务组织、实施绩效管理等措施，对改善市属医院系统整体住院服务绩效尤其是在减轻患者负担、提高服务效率等方面发挥了重要作用，但也提示要通过集团化建设与管理等措施不断提高市属医院系统的临床专科能力，提高IVIDC诊疗难度，回归三级医院职能。
文摘Background： With the rising incidence as well as the medical expenditure among patients with unstable angina pectoris, the research aimed to investigate the inpatient medical expenditure through the combination of diagnosis-related groups （DRGs） among patients with nnstable angina pectoris in a Grade A tertiary hospital to conduct the referential standards of medical costs for the diagnosis. Methods： Single-factor analysis and multiple linear stepwise regression method were used to investigate 3933 cases between 2014 and 2016 in Beijing Hospital （China） whose main diagnosis was defined as unstable angina pectoris to determine the main factors influencing the inpatient medical expenditure,and decision tree method was adopted to establish the model of DRGs grouping combinations. Results： The major influential factors of inpatient medical expenditure included age, operative method, therapeutic effects as well as comorbidity and complications （CCs） of the disease, and the 3933 cases were divided into ten DRGs by four factors： age, CCs, therapeutic effects, and the type of surgery with corresponding inpatient medical expenditure standards setup. Data of nonparametric test on medical costs among different groups were all significant （P 〈 0.001, by Kruskal-Wallis test）, with R2 = 0.53 and coefficient of variation （CV） 0.524. Conclusions： The classification of DRGs by adopting the type of surgery as the main branch node to develop cost control standards in inpatient treatment of unstable angina pectoris is conducive in standardizing the diagnosis and treatment behaviors of the hospital and reducing economic burdens among patients.
