基于诊断相关组的北京地区某中西医结合医院住院医疗绩效分析

目的对比2017年研究医院与标杆医院住院医疗指标,通过诊断相关组(DRGs)评价研究医院住院医疗绩效水平。方法选取2017年1～12月研究医院9760例住院患者为研究对象,涉及DRGs组数334组,以北京诊断相关组分组方式,分析研究医院出院病例与标杆医院的病例组合指数(CMI)、费用效率指数、时间效率指数、低风险死亡率、中低风险死亡率等指标。结果研究医院CMI为0.78,标杆医院0.98;研究医院费用消耗指数0.83,标杆医院0.90;研究医院时间消耗指数1.18,标杆医院1.09;研究医院低风险死亡率0.22%,标杆医院0.01%;研究医院中高风险死亡率6.45%,标杆医院2.96%;研究医院高风险死亡率25.81%,标杆医院19.62%。结论与标杆医院对比,研究医院DRG组数少,CMI偏低,费用消耗指数偏低,时间消耗指数偏高,低风险死亡率偏高,中高风险及高风险死亡率高于标杆医院。数据说明研究医院疾病诊疗广度低于标杆医院,医疗技术难度低于标杆医院,平均住院日高于标杆医院。诊断相关组可做为评估医院医疗质量的方法。

Analysis of medical performance of a hospital of integrated Chinese and Western medicine in Beijing based on diagnosis related group

Objective To compare the medical indicators of 2017 of the research hospital and the benchmarking hospital and to evaluate the in-hospital medical performance levels of the research hospital by the diagnosis related groups (DRGs). Methods 9760 hospitalized patients in the research hospital from January to December 2017 were selected as the research subjects, including 334 DRGs groups. The case mix indexes (CMI), cost efficiency indexes, time efficiency indexes, low risk mortalities and middle and lower risk mortalities of discharge cases of the research hospital and the benchmarking hospital were analyzed by the grouping method of Beijing diagnosis related groups. Results The CMI of the research hospital was 0.78, which was 0.98 in the benchmarking hospital. The cost consumption index of the research hospital was 0.83, which was 0.90 in the benchmarking hospital. The time consumption index of the research hospital was 1.18, while that of the benchmarking hospital was 1.09. The low risk mortality in the research hospital was 0.22%, while that of the benchmarking hospital was 0.01%. The middle and high risk mortality in the research hospital was 6.45% and that of the benchmarking hospital was 2.96%. The high risk mortality in the research hospital was 25.81% and that of the benchmarking hospital was 19.62%. Conclusion Compared with the benchmarking hospital, the number of DRG groups in the research hospital is less. The CMI and the cost consumption index of the research hospital are lower, while the time consumption index, the low risk mortality, the middle and high risk mortality and high risk mortality are higher than those of the benchmarking hospital. These data show that the breadth of diagnosis and treatment in research hospital is lower than that in the benchmarking hospital, while the difficulty of medical technology is lower than that of benchmarking hospital. The average length of stay of research hospital is higher than that of benchmarking hospitals. Diagnosis related group can be used as a method to evaluate the quality of medical care in hospitals.