基于病种的精细化医疗管理模式研究与实践

目的 以肺部专科疾病为主要研究内容，探索基于病种的精细化医疗管理模式。方法 借鉴澳洲版DRGs体系，建立医院病种分类目录，并按病种目录进行绩效评价与考核。结果 实施病种管理以来，病例组合指数（CMI）呈明显升高趋势，从2013年0.94提高到2016年的1.04；医疗费用指标基本保持稳定；6个医疗质量指标有明显提高。结论 按病种管理有利于优化医院病种结构调整、控制医疗费用以及保证医疗质量。

Research and Practice on the Precise Medical Management Model Based on DRGs

Objective To explore a precise medical management model based on DRGs, within the special scope of lung diseases. Methods Through taking Australian version of DRGs as an example, the disease catalogue category was established, and performance evaluation was done according to the catalogue. Results After the implement of precise management based on DRGs, CMI increases from 0.94 in 2013 to 1.08 in 2016; the medical expense indicator remains stable; 6 medical service quality indicators have increased dramatically. Conclusion DRGs precise management based on DRGs helps to optimize the DRGs structure, control medical expense and guarantee medical quality.