Study On Medical Service Performance Evaluation Of Public Hospitals Under The Background Of DRGs Payment Reform

By the time the total health expenditure in China reached 5.259828 trillion yuan in 2017,the proportion of China’s total health expenditure in GDP had increased from3% in 1978 to 6.4% in 2017.At the same time,the proportion of government health investment in GDP was only 1.83% in 2017,and personal cash health expenditure accounted for 28.77% of the total health expenditure.It shows that on the one hand,our country does not reasonably control the rising trend of total health expenditure,on the other hand,in the countries dominated by public hospitals,the government’s investment in the field of health is obviously insufficient,and the practical problem that it is difficult and expensive for people to see a doctor has not been completely solved.Hospitals are not only the core institutions in the medical service system,but also the core main body of the output of medical service performance.at present,there are common problems in medical institutions at all levels in China: different service providers treat different patients.the patients treated in different departments are very different,and the cases in different hospitals are even more different.how to compare is the most difficult problem in medical service performance evaluation,and it is difficult to compare their performance.DRGs classifies different cases according to certain rules for hospitalized patients.Based on the fact that DRGs can be applied to the performance evaluation of medical services in hospitals,the evaluation contents include six performance indicators in three dimensions: ability,efficiency,quality and safety of medical services.Hospitals have improved their management level and discipline construction ability.Patients not only provide high-quality medical services to hospitals,but also reduce their economic burden during hospitalization.This paper first introduces the background,significance,research difficulties,innovation and the summary of the current research situation at home and abroad,then introduces the experience and practice of performance evaluation based on DRGs in Yunnan Province,and then mainly takes the early pilot hospital in LijiangCity,Yunnan Province,which is based on DRGs application of in-patient medical service performance evaluation,as the research object to carry on the performance evaluation results and analysis.Research materials and analysis methods: the DRGs basic database comes from the standard data of the first page of HQMS medical records reviewed and reported by Lijiang public hospitals.Collect and sort out the relevant chart data of DRGs performance evaluation indicators reported in Lijiang City,and then summarize and analyze the data of six DRGs performance evaluation indicators in Lijiang public hospitals from 2018 to 2019.Research results: after the performance evaluation based on DRGs,Lijiang people’s Hospital ranks first in the comprehensive evaluation of six performance indicators in the three dimensions of medical service capacity,efficiency,quality and safety,the other six second-level general hospitals also perform well in the performance evaluation,and the quality and level of medical services in the city have been significantly improved."Lijiang Model" is worth popularizing and applying in the whole province and even the whole country.Finally,the paper puts forward some suggestions on the performance evaluation of public applications based on DRGs in Lijiang City.