探究DRGs在皮肤诊治医疗服务评价中的应用

目的探讨DRGs视角下控费政策对皮肤诊治医疗服务的影响,为皮肤病医院精细化管理提供方向。方法以“某省疾病诊断相关分组医疗服务管理系统”为研究平台,对某三级皮肤病医院2016—2018年DRGs运行数据进行比较分析,包含DRGs能力指数、服务效率、医疗安全3个维度,共8个指标。结果DRGs组数从108增加到110后降低至91;总权重从1903.6增加到2729.8;病例组合指数(CMI)稳定于0.77~0.78;学科建设从1.48增加到1.51;时间消耗指数从1.21降低到1.06;费用效率指数徘徊于1.31~1.40;低风险死亡率、中低风险死亡率均为0。结论DRGs具有较为公平公正的评价指标,能从多维度客观、合理、有效地评价皮肤诊治医疗服务能力,能够让不同等级、类型的医院在同一标准下进行评价,促进医院的发展。

Exploration of DRGs Application in the Evaluation of Medical Service of Skin Diagnosis and Treatment

Objective:To explore the influence of fee control policy on skin diagnosis and treatment from the perspective of DRGs,and to provide direction for the refined management of dermatological hospital.Method:The DRGs operation data of a grade-three dermatological hospital from 2016 to 2018 were compared and analyzed by taking the“medical service management system of a provincial disease diagnosis related grouping”as the research platform,including 3 dimensions of DRGs capability index,service efficiency and medical security,and a total of 8 indicators.Result:The number of DRGs group decreased from 108 to 110 to 91.Total weight increased from 1,903.6 to 2,729.8.The case combination index(CMI)was stable between 0.77 and 0.78.Discipline construction increased from 1.48 to 1.51;Time consumption index decreased from 1.21 to 1.06.The cost-efficiency index hovered between 1.31 and 1.40.Low risk mortality and low risk mortality were all 0.Conclusion:DRGs has relatively fair and impartial evaluation indexes,which can objectively,reasonably and effectively evaluate the ability of skin diagnosis and treatment,and medical service from a multi-dimensional perspective.It enables hospitals of different grades and types to evaluate under the same standard and promote the development of hospitals.