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中文摘要: 目的 基于疾病诊断相关组（DRG）的上海市嘉定区某二级综合性医院的医疗服务质量与绩效评价干预模式进行分析，为 建立公立医院绩效考核评价机制提供参考依据。方法 本组以“DRG住院医疗服务监测与分析系统”等为研究平台，通过在线上报 的病案首页信息，对某二级综合性医院2018—2019年基于DRG的住院患者入组病例数、CMI值、DRG组数和总权重等指标进行比 较，同时对区域病种难度、区域手术难度以及MDC医疗服务能力、效率和安全进行比较，并从三个维度进行综合分析。结果 2018年总病例数12464例，入组病例数12398例，入组率为99.47%；2019年总病例数12301例，入组病例数13037例，入组率 为99.51%。其中DRG组数上升了7.94%，CMI值上升了9.64%，呈良好发展态势。产能、效率、安全和综合得分均呈上升趋势， 其中安全得分上升了12.66%，综合得分上升了6.12%。MDC医疗服务能力、效率和安全和去年同期相比也呈上升趋势。结论 基 于DRG的医疗服务绩效评价具有科学性、客观性和可比性的特点，可以帮助医疗机构发现医疗行为存在的问题，有的放矢地进行 干预，通过DRGs这个管理工具在费用控制、质量管理、安全控制、学科评估和绩效评价等方面发挥其综合作用。
Abstract:Objective The analysis of the intervention mode of medical service quality and performance evaluation of a secondary comprehensive hospital in Jiading, Shanghai, based on DRGs, provides a reference basis for the establishment of the performance evaluation mechanism of public hospitals. Methods This group uses "DRG Inpatient Medical Service Monitoring and Analysis System" as the research platform to compare the number of DRGs-based inpatient admissions, CMI values, DRG group numbers and total weights of a secondary general hospital from 2018 to 2019 through the online reporting of the first page information of the patient stort, and compares the difficulty of regional diseases, regional surgery and MDC medical service capacity, efficiency and safety. Results The total number of cases in 2018 was 12,464, the number of incoming cases was 12,398, the rate of accession was 99.47%, and in 2019 the total number of cases was 12,301, and the number of cases in the group was 13,037, with a group rate of 99.51%. Among them, the number of DRGs increased by 7.94%, and the value of CMI increased by 9.64%, showing a good development trend. Capacity, efficiency, safety and overall scores all showed an upward trend, with safety scores up 12.66 per cent and composite scores up 6.12 per cent. MDC's medical service capacity, efficiency and safety are also on the rise compared to the same
period last year. Conclusion Based on the characteristics of scientific, objective and comparable characteristics of THE performance evaluation of DRGs, it can help medical institutions to find the problems of medical behavior, intervene in a targeted manner, and play a comprehensive role in cost control, quality management, safety control, subject evaluation and performance evaluation through DRGs as a management tool.
keywords: diagnosis related groups （DRGs） quality of medical service performance evaluation intervention model
文章编号：3202008007 中图分类号：R197 文献标志码：
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