| Background:With the development of society,the improvement of people’s living standard and the change of life style,residents’ requirements for medical and health care are increasing day by day,and the demand tends to be high-quality medical services.Medical service quality is a measure of national medical and health undertakings development and the evaluation standard of hospital management level,to evaluate its is closely related to the interests of the public,to the hospital at the same time is also important basis for quality control and appraisal,how fair,fair and reasonable to evaluate medical service quality has become a problem to be solved.Previous studies have found that the traditional indicators of medical service performance evaluation system lack consideration of differences in disease composition and disease difficulty,and lack of horizontal comparison in evaluation results,resulting in inaccurate and scientific evaluation results.Than traditional indicators of performance evaluation system of medical service,medical service performance evaluation system based on DRGs index,can not only use case mix tool for disease risk adjustment,but also for different types and evaluate the difficulty differences,ward disease treated at the same time can take into account different ward medical resources consumption,the results of medical service performance evaluation are more objective and reasonable,and the effect of improving medical service quality is more prominent.Objective:DRGs index and traditional index were used to evaluate the medical service performance in each ward of a third grade a hospital in Henan Province.This paper analyzes the advantages and disadvantages of the two in the evaluation of medical service performance,and focuses on the analysis of the medical service performance level of the three key wards of the hospital,so as to understand the hospital’s medical service ability,medical service efficiency and medical service security of the three basic conditions;according to the evaluation results,the length of stay and cost of hospitalization in the three key wards were analyzed to provide reference for the hospital to improve medical service capacity and medical service efficiency.Methods:Data of 29250 discharged patients with DRGs disease from 62 departments of a third grade A hospital in Henan Province from January to December 2020 were selected.The comprehensive evaluation method was used to process the related data,and the weight stratification method was used to analyze the structure of the difficulty and complexity of diagnosis and treatment.After data information was checked,it was imported into SPSS25.0 software for descriptive statistical analysis,Chi square test and rank sum test.P<0.05 was considered statistically significant.Results:1.By using the comprehensive evaluation method,the medical service performance of each ward of the hospital was evaluated.According to the evaluation results,the top five departments were the third ward of cardiovascular medicine(5.792),the first ward of general surgery(5.390),the first ward of thoracic surgery(4.664),the second ward of cardiovascular medicine(3.662)and the second ward of gastroenterology(3.260).The top five departments of medical service performance evaluation based on traditional indicators were pediatrics(3.890),second ward of Gastroenterology(3.674),first ward of gastroenterology(3.588),second ward of cardiovascular Medicine(3.096),and second ward of neurology(2.986).2.Results of DRGs index medical service performance evaluation of the three key wards of the hospital: Among the cardiovascular wards,the medical service performance of the third ward was higher than that of the first and second wards.In the department of gastroenterology,the medical service performance of the first ward was higher than that of the second ward.In general surgical wards,ward 1 of general surgery was higher than ward 2 of general surgery.The results showed that the performance evaluation results of the three key wards of the hospital were consistent with those of the traditional indicators and DRGs.The medical service performance of ward 3 was higher than ward 1 and ward 2.In the department of gastroenterology,the medical service performance of the first ward was higher than that of the second ward.In general surgical wards,ward 1 of general surgery was higher than ward 2 of general surgery.3.By using the weight stratification method,the weight was divided into three levels according to the difficulty of the disease,namely W≤1.0(low difficulty disease category),1.02(high difficulty disease category).Among them,W≤1.0(8330 cases),1.02(5865 cases),indicating that the hospital treated the most cases in 1.0 The department with the largest number of cases in W>2.0(highly difficult disease category)was ward 3 of cardiovascular Medicine,with 331 cases and a constituent ratio of 9.82%.The department with the largest number of cases in 1.0,the department with the largest number of cases in W≤1.0(low-difficulty disease category)was pediatrics,with 594 cases and a constituent ratio of 7.04%.4.The difficulty of diseases in the three key wards of the hospital showed that the department with the most cases of 1.0 The number of cases in ward 3 of the Department of Cardiovascular Medicine was the largest in W>2.0(category of difficult diseases),with 331 cases and a constituent ratio of 46.69%.Among the wards of gastroenterology,ward 2 of gastroenterology had the largest number of cases with W>2.0(593 cases,composition ratio 53.96),while ward 1 of gastroenterology had the largest number of cases with W < 2.0(526 cases,composition ratio 53.84%).Among the general surgical wards,ward 1 of general surgery had the largest number of cases with W>2.0,with 306 cases and a constituent ratio of63.88%.5.Distribution of diseases in three key wards of the hospital: In the department of cardiovascular medicine,ward 1,ward 2 and Ward 3 mainly treated FM33(percutaneous cardiac catheterization with common complications and complications),FR33(angina pectoris with common complications and complications),and BR23(cerebral ischemic diseases with common complications and complications),respectively.In the department of gastroenterology,GK23(gastroscopic treatment with general complications and complications)and GK33(colonoscopic treatment with general complications and complications)were mainly treated in the first and second wards of the department of gastroenterology.Among the general surgical wards,the first and second wards of general surgery mainly treated HC33(cholecystectomy,with general complications and complications)and RF13(end-stage treatment of malignant hyperplastic diseases,with general complications and complications)respectively.6.The results of time consumption index showed that the length of stay in three key wards of the hospital was lower than that in ward one and two of cardiovascular ward three,lower than that in ward one of gastroenterology ward two and lower than that in ward one of general surgery ward two.The results of cost consumption index showed that the inpatient expenses in three key wards of the hospital were higher in cardiovascular ward 3 than in ward 1,the average inpatient expenses in gastroenterology ward 2 were lower than in ward 1,and the inpatient expenses in general surgery ward 1were lower than in ward 2.Conclusion:1.Compared with the traditional indicators of performance evaluation of medical services,based on the DRGs index evaluation system for medical service,not only through use case mix tool for disease risk adjustment,avoid the deviation in the results,and able to take into account the different department disease to the difficulty,the difference of the objective response to different department of the medical service level,Effectively guide the department to recognize their own development direction and functional positioning.2.In this study,DRGs group number,CMI,total weight and other indicators are positively correlated with medical service capacity;cost consumption index and time consumption index are negatively correlated with medical service efficiency;low risk mortality index is negatively correlated with medical service safety.3.In the process of clinical diagnosis,the more serious complications and complications are found,the more complicated the diagnosis and treatment of diseases will be,and the more medical resources will be consumed.Therefore,the medical service performance evaluation system based on DRGs plays an important role in evaluating the difficulty and complexity of diseases in different departments.Suggestions1.Improve the quality of medical record home page information,improve the DRGs related knowledge level of medical staff.2.Improve the hospital DRGs medical service performance management mechanism,promote the continuous development of medical and health services in all departments.3.Strengthen discipline construction and promote balanced development of discipline. |
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