摘要
目的基于疾病诊断相关分组(DRGs)绩效评价指标,评价广东省公立医院综合改革在医院的实施成效,为医院后续的改革推进提供参考。方法以广东省某三级甲等医院为例,选取2016~2018年收治患者的病案首页,以2017年7月为改革时间段划分,比较改革前后医院收治患者的基本特征和DRGs绩效指标的差异。结果综合改革后DRG组数增加,例均权重和时间消耗指数较改革前降低(P<0.001),改革前后的费用消耗指数和中低风险组死亡率比较,差异无统计学意义(P>0.05)。出院人数前10位DRGs组中,改革后权重低于1且下降的有4个,费用消耗指数大于1且增加的有4个。结论公立医院综合改革后,医院在确保医疗服务安全的同时,医疗服务能力和时间效率有所提高,但需重视增强疑难重症的救治能力、提高外科专科的收治水平,控制患者医疗费用的增长。
Objective To evaluate the effect on comprehensive reform of public hospitals in a hospital in Guangdong basing on diagnosis related groups(DRGs),,and provide suggestion for the reform.Methods The inpatient medical records from 2016 to 2018 in a hospital in Guangdong were selected,and compared the differences in basic characteristics and DRGs indexes between groups before and after comprehensive reform.The reform time point was set in July 2017.Results It was showed that the number of DRG groups increased.In addition,average weight and time consumption index was lower after reform(P<0.001).It did not revealed significant difference of cost consumption and low-and medium-risk mortality rates between the groups before and after reform(P>0.05).Among the top ten DRGs groups,average weight of four groups was lower than 1 and decreased after reform,but cost consumption index of four groups were higher than 1 and increased.Conclusion In the comprehensive reform of public hospitals,the capacity and time efficiency of medical service are improved in hospital,and the security of medical service security is not affected.It′s suggested that the hospital should pay more attention to the ability on treating difficult and severe patients,and improve the level of surgical specialty,so as to control patients′medical costs better.
作者
刘苑婷
何丽萍
黄国标
方家尉
陈宇玲
LIU Yuan-ting;HE Li-ping;HUANG Guo-biao;FANG Jia-wei;CHEN Yu-ling(Department of Medical,Guangzhou Panyu Central Hospital,Guangdong Province,Guangzhou511400,China)
出处
《中国当代医药》
2020年第32期168-171,共4页
China Modern Medicine
基金
广东省广州市番禺区医疗卫生项目一般项目(2018-Z04-41)。
关键词
综合改革
医药分开
公立医院
疾病诊断相关分组
Comprehensive reform
Separation of medicine
Public hospital
Diagnosis related groups
作者简介
刘苑婷(1985-),女,硕士,统计师/主管技师,研究方向:卫生统计、疾病诊断相关分组。
