基于DRGs的老年医学科医疗服务绩效评价研究

目的 应用DRGs管理工具对医院老年医学科常见疾病类型的医疗服务绩效状况进行初步探讨.方法以BJ-DRGs为分组方式,选取某医院2013—2014年老年医学科呼吸、神经、循环系统常见疾病类型的老年患者(年龄≥60岁)出院病例,分别与同期呼吸科、神经内科、心脏科老年患者(年龄≥60岁)出院病例进行医疗服务绩效指标比较分析.结果 老年医学科呼吸、神经、循环3个系统收治疾病DRG组数分别为15,19,19,均低于专业科室;呼吸系统CMI值为1.57,高于专业科室;循环系统CMI值为1.08,低于专业科室;时间消耗指数呼吸、神经、循环系统分别为1.48,1.17,1.45,均高于专业科室;费用消耗指数呼吸、神经系统分别为1.60,1.26,分别高于专业科室,循环系统为0.99,低于专业科室.结论 老年医学科诊治的病种类型还有待扩增,在循环系统方面的诊疗水平还需进一步提高;同时老年医学科整体医疗服务效率偏低.

Evaluation of Medical Service Performance in the Department of Geriatrics Based on the DRGs

Objectives To investigate the situation of medical service performance of the common diseases in the elderly in our hospital by DRGs.Methods According to BJ-DRGs,we selected elderly patients(≥60 years)hospital-ized in the department of geriatrics from 2013 to 2014,who were suffered respiratory system diseases,nervous sys-tem diseases,circulatory system diseases,compared to the elderly patients(≥60 years)hospitalized respectively in the same period in the Department of respiratory,neurology,cardiology.Medical service performance indicators were e-valuated.Results the numbers of DRGs for respiratory,neurology,cardiology in the department of geriatrics were 15,19,19 respectively,which were lower than that of professional departments.The value of CMI for respiratory system diseases was 1.57 and higher than that of professional department.The value of CMI for circulatory system diseases was 1.08 and lower than that of professional department.The values of time consuming index for respirato-ry,neurology,cardiology in the department of geriatrics were 1.48,1.17,1.45,respectively,which were higher than that of professional departments.The values of cost consuming index for common diseases in the department of geri-atrics were higher than that of professional department except circulatory system diseases.Conclusions The diagno-sis and treatment of disease types in the department of geriatrics remains to be expanded,and the clinical treatment of the circulatory system should be further improved.The medical service efficiency is low.