CAJ | 학술논문

绩效考评是正面引导公立医院行为、促进医院健康持续发展的有效手段。在绩效考评中引入疾病危重程度，有利于提高绩效考评体系的科学合理性，促进医院医疗技术水平和服务能力的提升。在上海市级医院疾病诊断分组系统的基础上，本研究利用病例组合指数对不同类型医疗机构收治病例的危重程度进行评价，并根据疾病危重程度加权赋值后获得病种难度考核得分。研究发现，在DRG分组基础上计算的不同医疗机构的病例组合指数，具有显著性差异，能有效体现不同医疗机构所收治住院病例的疾病危重程度和救治难度。建议优选科学指标，优化考核办法，建立有效监督和动态更新的工作机制，并探索疾病诊断分组的拓展应用。
적효고평시정면인도공립의원행위、촉진의원건강지속발전적유효수단。재적효고평중인입질병위중정도，유리우제고적효고평체계적과학합이성，촉진의원의료기술수평화복무능력적제승。재상해시급의원질병진단분조계통적기출상，본연구이용병례조합지수대불동류형의료궤구수치병례적위중정도진행평개，병근거질병위중정도가권부치후획득병충난도고핵득분。연구발현，재DRG분조기출상계산적불동의료궤구적병례조합지수，구유현저성차이，능유효체현불동의료궤구소수치주원병례적질병위중정도화구치난도。건의우선과학지표，우화고핵판법，건립유효감독화동태경신적공작궤제，병탐색질병진단분조적탁전응용。
The performance evaluation is an effective method to guide the public hospitals behavior and pro-mote their sustainable development.The introduction of disease severity could make the performance evaluation sys-tem more scientific and reasonable, and encourage the hospitals to improve their technical skills and services ability. Based on the Shanghai diagnosis related groups system, a case-mix index ( CMI) was introduced and a severity score of disease was developed after the relative weight ( RW) adjustment to evaluate different types of disease severity in hospitals.The results have shown that CMI effectively reflects the patients'disease severity and the intensity of treat-ment in those hospitals taken into consideration.Therefore, the scientific indicators should be selected and the evalu-ation system should be improved thereby establishing an effective monitoring and dynamic adjustment mechanism and further developing the diagnosis related group application.