DRG支付制度改革中医务人员诊疗行为调查研究

目的对疾病诊断相关分组(DRG)支付制度改革中医务人员的可能诊疗行为进行分析,为推动改革提供参考。方法通过问卷调查,对医务人员在DRG下的可能行为进行研究,通过因子分析和聚类分析,提取了可能行为的公因子,分析了人口学特征的影响,并对人员群体进行了划分。结果医务人员的可能行为分为负向医疗行为和正向医疗行为2大类,其下包含28个二级指标。人口学特征中,男性医生更倾向于采用负向医疗行为,职务职级较高、对DRG支付制度熟悉的人员更倾向于正向医疗行为。人员群体可细分为适应型群体和逆反型群体。结论医务人员采取正向医疗行为的可能性大于采取负向医疗行为的可能性。应注意不同人口学特征对医务人员诊疗行为的影响。对不同的细分群体在改革中采取不同的管理策略,重点使用适应型群体,引导并转变逆反型群体的思想行为。

Investigation on Medical Staff’s Diagnosis and Treatment Behavior in DRG Reform

Objective To analyze the possible diagnosis and treatment behaviors of medical staff in the reform of DRG,and to provide reference for promoting the progress of the reform.Methods Through questionnaire survey,the possible diagnosis and treatment behaviors of medical staff under DRG were studied.Through factor analysis and cluster analysis,the common factors of possible behaviors were extracted,the influence of demographic characteristics was analyzed,and the personnel groups were divided.Results The possible behaviors of medical staff were divided into two categories:negative medical behavior and positive medical behavior,which included 28 secondary indicators.Among the demographic characteristics,male doctors are more inclined to adopt negative medical behavior.People with higher positions and familiar with DRG system tend to adopt positive medical behavior.Personnel groups can be subdivided into adaptive groups and reverse groups.Conclusion It is more likely for medical staff to adopt positive medical behavior than negative medical behavior.Attention should be paid to the influence of different demographic characteristics on medical staff’s diagnosis and treatment behavior.Different management strategies are adopted for different sub-groups in the reform,focusing on the use of adaptive groups and changing the thinking and behavior of reverse groups.