Research On Performance Evaluation Of Hospital Medical Service Based On DRGs

Nowadays,people's requirements for medical level and medical services are higher and higher because of the development of society and the improvement of economic living standards.However,the performance of medical services in the process of medical diagnosis and treatment is still unstandardized and unified,which leads to long hospital performance accounting time and inaccurate data.Therefore,a new system is urgently needed to solve these deficiencies.This system should emphasize not only service results,but also importance of target management and total quality management.Currently,DRGs(diagnosis-related groups)are recognized as the best choice.With the introduction of the DRGs system at the national level,various localities are also actively working to apply DRGs to hospital performance management and truly localizing DRGs.This article takes a third-class general hospital as a sample hospital to analyze the medical service performance evaluation of some clinical departments before and after CMI intervention adjustment,in order to explore a set of DRGs system that is suitable for the sample hospital.This paper first summarizes the existing research results at home and abroad,and from the perspective of historical development process,theoretical basis and application process,combined with the relevant research of DRGs cost accounting in public hospitals.At the same time,pre-selection and determination of key indicators were carried out through questionnaire surveys,combined with expert consultation and expert evaluation,and finally constructs a medical service performance evaluation index system including four dimensions of ability,efficiency,quality and patient satisfaction.Set evaluation indicators,establish an evaluation index system and set weights to determine the final evaluation criteria.Immediately afterwards,the medical service performance about from clinical departments(two non-surgical departments,which are endocrinology and cardiology;two operating departments,which are breast and cardiovascular surgery)in the past three years were evaluated.The performance of inpatient medical service was evaluated and verified.Compared the differences of medical service performance evaluation before and after the intervention adjustment of CMI value.According to the results,we analyzed and judged the reasons about the differences and analyzed the rationality of the evaluation results from four different dimensions.From the analysis results,we can see that traditional performance evaluation could guide the department to request the number of patients blindly,which lead to overcrowding of patients in the department and the decline in medical standards,after adjusting the efficiency indicators of the department using the CMI value could avoid such risks effectively.This research found that DRGs evaluated the performance of medical services.Through the CMI value,the targeted risk adjustment of the medical service performance indicators greatly improved the feasibility of the evaluation results,and reduced the replacement cost caused by changing the evaluation system.Therefore,DRGs have a significant corrective effect in evaluating the ability,quality and safety of medical services,and can effectively standardize the behavior of clinical departments and guide the development direction of sample hospital.