单病种费用控制KPI设计与基于DSS的应用

目的：研究建立基于DSS的单病种费用关键业绩指标监控体系，为提高单病种诊疗质量、减少不合理费用的发生提供辅助决策支持。方法：参考建立KPI的SMART原则，围绕单病种临床诊疗流程，采用鱼骨图的方法从诸多发生费用的医疗行为中梳理归纳主要影响因素，构建单病种费用监控KPI；应用医院ODS中的“卵巢良性囊肿手术”单病种在线诊疗数据，进行基于DSS的KPI应用测试。结果：建立了包括患者自身因素、医疗行为因素、诊疗效果因素3大类31项内容的单病种费用控制KPI体系和基于DSS的单病种费用KPI监控模式。结论：KPI具有较强的内容聚集性和目标测量性，应用其提供DSS服务，能够辅助医院管理者有的放矢地实施单病种费用控制。

Design and application of key performance indicator for single disease cost control based on decision support system

Objectives： To explore a DSS-based single disease cost KPI （key performance indicators） monitoring system for decision supporting in improving disease diagnostic and therapeutic quality, and decreasing unrealistic costs. Method： SMART principle was referred to establish KPI monitoring system for single-disease cost. Following the process of medical service, fishbone diagram was used to analyze the main factors influencing medical service cost and design KPI system for single disease cost monitoring. By applying the online data about operation for benign ovarian cysts which came from hospital ODS （Operational Data Store） system for testing. Results： A KPI system monitoring system based on DSS for single disease cost control was established. The KPI system included three major components as well as patient characteristics, medical behavior factors and medical service effectiveness. Conclusions： KPI system has good reliabilities and validity, the indictors are measurable. It could assist the hospital managers to efficiently implement the target oriented monitoring and control on disease cost.