摘要
目的基于诊断相关分组(Diagnosis Related Groups,DRGs)管理下结合CMI指数与时间基础率探讨制定平均住院日标准值的合理性。方法某三甲医院某科室2014—2017年出院患者的信息,首先运用边际医疗费用法计算科室的平均住院日理想值,然后使用方法一(未考虑病例组合指数)与方法二(结合病例组合指数)制定科内各医生平均住院日标准值,最后对两者进行对比分析,探讨各医生合理住院日。结果科室的平均住院日理想值为7. 44 d,科室CMI指数为1. 01。若医生的CMI指数大于科室CMI指数,说明该医生收治病患技术难度高于科内平均技术难度,则方法二中指定的平均住院日标准值高于方法一中数值更为合理。反之亦然。结论结合CMI与时间基础率制定的平均住院日标准值更符合实际情况,用于衡量医生工作效率更有说服力。
Objective ：To explore and disaiss the rationality of the average hospitali/ab CMI index with time base rate,basing on diagnosis related groups （ DRGs）. Method：With the information ot the discharged patients from the department ot a hospital ot Class A,Grade Three from 2014 to 2017,marginal medical expenses ot ideal average hospitali- /ation day are calculated first and then the average hospitali/ation day standard value of each doctor （ excluding the case-mix index referred to as Method 1） and （including the case-mix index referred to as Method 2） are used Finally,the average hospitalization day standard values of each doctor are explored and discussed with the compared analysis on the two methods. Result：The results show that the ideal average hospitalization day in the department is 7. 44 D and CMI index of the department is 1. 01. If CMI index of each doctor is greater than that of the department,the doctor contributes more sophisticated technology than the average in the department ,which means that it is reasonable the average hospitalization day standard value of Methods 2 is greater than that of Method 1. And vice versa. Conclusion ：The average hospitalization day standard value on the basis of CMI and time base rate is more realistic and more persuasive in measuring a doctors effectiveness.
作者
莫茗荞
韦秀碧
朱铭
林泽东
MO Ming-qiao;WEI Xiu-bi;ZHU Ming;LIN Ze-dong(Affiliated Hospital of Zunyi Medical college,Zunyi,Guizhou 563000,China;Guizhou Zhongzhuang Prison,Zunyi,Guizhou 563000,China)
出处
《现代医院管理》
2018年第4期36-39,共4页
Modern Hospital Management
基金
国家自然科学基金项目(gzw jkj2016-1-012)
关键词
病例组合指数
边际医疗费用
平均住院日
CMI index
marginal medical expenses
the average hospitalization day
作者简介
通信作者：韦秀碧（1962-），女，本科，副主任护师；研究方向：病案管理。
