转科因素对应用DRG进行科室绩效评价的影响

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英文篇名：The Influence of Transfer Factors on Applying DRG on Department Performance Evaluation 作者：刘冬生 英文作者：LIU Dong-sheng;The First People's Hospital of Foshan; 关键词：疾病诊断相关分组 ; 科室绩效评价 ; 转科因素 英文关键词：Diagnosis Related Group;;department performance evaluation;;transfer factor 中文刊名：WEIJ 英文刊名：Chinese Health Economics 机构：佛山市第一人民医院; 出版日期：2019-07-05 出版单位：中国卫生经济 年：2019 期：v.38;No.437 语种：中文; 页：WEIJ201907027 页数：4 CN：07 ISSN：23-1042/F 分类号：78-81

摘要

目的:分析转科因素对将疾病诊断相关分组(DRG)用于科室评价结果的影响。方法:以剔除药品和耗材后的住院医疗费用各科构成作为依据,对每一例发生了转科的病例的住院人次和权重进行拆分,重新计算各科总权重和病例组合指数(CMI)。结果:转科病例越多的科室,其调整后总权重的变化也越大,变大者最大达到117.31%,变小者最小-25.96%,变化幅度绝对值在5%以上的科室有12个,占18.75%;CMI值变大者最大3.17%,变小者最小-21.72%,变化幅度绝对值在5%以上的科室有6个,占9.38%。结论:DRG用于不同科室之间的评价时须考虑转科因素。
        Objective: To analyze the influence of transfer factors on DRG used in department evaluation results. Methods:Based on the composition of each department of hospitalization expenses after eliminating drugs and consumables, the number and weight of hospitalized patients in each case were divided. The total weight of each department and case combination index(CMI) were recalculated. Results: The greater the number of transferred cases were, the greater the change of the total weight after adjustment would be. The biggest change was 117.31%, the smallest change was-25.96%. There were 12 departments with absolute variation above 5%, accounting for 18.75%. The biggest change of CMI was 3.17%, and the smallest change was-21.72%. There were 6 departments with absolute variation above 5%, accounting for 9.38%. Conclusion: Transfer factors should be taken into account when DRG were used to evaluate different departments.

引文

[1]谢世堂.基于DRG的出院人次相对价值评价方法研究[J].中国卫生经济,2016,35(3):79-81.
    [2]郭志伟. RGs的原理与方法及在我国的应用对策[J].中国卫生经济,2010,29(8):37-39.