疾病诊断相关组在医院绩效评价中的应用探讨

目前,尽管国内外关于医院绩效评价的研究较多,但普遍存在评价结果缺乏可比性的不足。其主要原因是不同医院收治的疾病类型不同、治疗难度和风险差别较大。基于DRGs的医院绩效评价方式为研究打开了思路。本文在明确当前公立医院绩效评价内容的基础上,指出了基于DRGs开展医院绩效评价的两个条件,即统一优质的数据和完善的信息系统,阐述了评价的三个维度,即医疗服务产出、效率和质量,并就上述三个维度内的相关评价指标的计算方法进行了说明。本文最后给出了基于DRGs开展医院绩效评价的五点现实意义:一是有助于优化医院内部成本结构;二是有助于规范科室临床路径工作;三是创新科室或医生的绩效考核方式;四是形成政府与医院间的长效监管机制;五是有助于探索DRGs付费模式在全国的推广。

Discussion on the Application of Diagnosis Related Groups in Hospital Performance Evaluation

At present, there are lots of studies about hospital performance evaluation at home and abroad, but usually evaluation results are the lack of comparability. This phenomenon is thought to be due to different hospitals, different disease types, different treatment difficulty and different risk. Hospital performance evaluation based on DRGs opens up the research train of thought. This article has been clear about the content of public hospital performance on the current, and point out the two conditions, three evaluation dimensions and a number of parameter values about hospital performance evaluation based on DRGs. Among them, the two conditions are unified high-quality data and perfect information system, and three evaluation dimensions are medical service output, medical service efficiency and medical service quality. Finally, five practical significances about hospital performance evaluation based on the DRGs are given as follws: first, help to optimize the hospital internal cost structure; second, help to regulate department clinical pathway work; third, help to innovation department or doctor''s performance appraisal way; fourth, help to form long-term supervision mechanism between the government and the hospital; fifth, help to explore the DRGs payment model of the whole country.