CAJ | 학술논문

目的：探讨将DRGs相关指标作为主诊组的绩效考核指标对主诊医师进行考核的可行性。方法通过调取2014年某医院泌尿科599例出院患者病案首页信息，通过BJ-DRGs分组方法提取泌尿科5个主诊组的DRGs的病例组合指数、时间消耗指数、费用消耗指数、DRGs组数四项指标进行比对，用以分析5个主诊组在临床工作效率上的差别，并对主诊组工作不足做出追踪分析。结果根据各主诊组DRGs相关指标结果，主诊4组的病例组合指数（CMI）、DRGs组数表现最佳；泌尿科主诊4组在住院费用上控制不佳，尤其是在前列腺肿瘤病例上费用过高。时间消耗指数表明全科各主诊组均达到北京市标准，主诊1、2、3、5组在各方面表现均较可。各组费用消耗指数均高于北京市平均水平，泌尿科在整体住院费用上需努力控制。结论将DRGs的相关指标作为主诊组工作效率的绩效评价指标，可以细致分析每个主诊组的优劣，鼓励主诊医师收治疑难危重患者，从而达到合理控制医疗费用、提高工作效率的目的。
목적：탐토장DRGs상관지표작위주진조적적효고핵지표대주진의사진행고핵적가행성。방법통과조취2014년모의원비뇨과599례출원환자병안수혈신식，통과BJ-DRGs분조방법제취비뇨과5개주진조적DRGs적병례조합지수、시간소모지수、비용소모지수、DRGs조수사항지표진행비대，용이분석5개주진조재림상공작효솔상적차별，병대주진조공작불족주출추종분석。결과근거각주진조DRGs상관지표결과，주진4조적병례조합지수（CMI）、DRGs조수표현최가；비뇨과주진4조재주원비용상공제불가，우기시재전렬선종류병례상비용과고。시간소모지수표명전과각주진조균체도북경시표준，주진1、2、3、5조재각방면표현균교가。각조비용소모지수균고우북경시평균수평，비뇨과재정체주원비용상수노력공제。결론장DRGs적상관지표작위주진조공작효솔적적효평개지표，가이세치분석매개주진조적우렬，고려주진의사수치의난위중환자，종이체도합리공제의료비용、제고공작효솔적목적。
Objective To investigate the feasibility of taking DRGs related indicators as the performance assessment indexes for attending physicians. Methods The information in the home pages of 599 patients who discharged from the urology department of a hospital in 2014 were selected, to get 5 attending group data of urology department through the BJ-DRGs packet extraction method,including Case Mix Index(CMI), Time consumption index, Cost index and the number of DRGs groups, so as to analyze efficiency differences of the 5 attending groups in the clinical work, and make the tracking analysis of insufficient from the attending group work. Results According to the results of DRGs, the attending groups 4 performed best at CMI and the number of DRGs groups, while was poor in the control of average hospitalization expenses,especially high cost in prostate cancer cases. Time consumption index suggested that all the attending groups meet the standard in Beijing, attending groups 1, 2, 3 and 5 in all aspects of performance were available. Cost consumption index in every attending group was higher than the average level of Beijing, so we should control the overall cost of hospitalization in urology department. Conclusions Through introducing DRGs related indicators as the performance assessment indexes for attending physicians, we could make a detailed analysis of the pros and cons of each attending group, encourage attending doctors to treat more critically ill patients, so as to reach the goal of control hospitalization costs and improve the quality and efficiency of hospital.