基于DRGs的临床医疗质量评价体系

目的按照DRGs的分组统计理论,结合医院实际情况,构建一套全面可行的医疗质量评价体系,让医疗服务水平得以可信性评价。方法利用DRGs分组工具,将某院收治病种分组,与国内排名前38位的三级综合医院相应疾病组进行核心指标完成情况比对,获得各科室各疾病组的多项指标O/E值,分析O/E值能真实评价医疗服务效能。结果运用DRGs系统,每月能准确抓取不同科室、不同疾病组和不同医师的临床诊治信息,通过横纵向对比分析,有利于找出科室质量管理缺陷,促进临床重点专科打造。结论DRGs是一种高效的医疗管理工具,基于DRGs系统构建的临床医疗质量评价指标体系能有效推动医院精细化质量管理的落实,提升医院质量管理内涵。

Construction of Clinical Medical Quality Evaluation System Based on DRGs

Objective To establish a comprehensive and feasible medical quality evaluation system based on the DRGs theory of grouping statistics and combined with the actual situation of the hospital,so that the level of medical service can be evaluated reliably.Methods The DRGs grouping tool was adopted to divide the diseases admitted to a hospital into three groups compare their core indicators with those of the corresponding disease groups in the top 38 hospitals in China,in order to obtain the value of multiple indexes O/E of each disease group in each department,since analyzing the value of O/E can objectively reflect the effectiveness of medical services.Results By adopting DRGs system,the clinical diagnosis and treatment information of different departments,different disease groups and different doctors can be accurately generated every month.Through the horizontal and vertical comparative analysis,it is helpful to find out the defects of quality management in the departments and to promote the establishment of the key clinical specialties.Conclusion DRGs system is an efficient medical management tool.The evaluation index system of clinical medical quality based on DRGs system can effectively promote the implementation of refined hospital quality management and enrich its connotation.