Research On Hospital Performance Management Based On Diagnosis Related Groups Model

As the economy in our country develops in a high speed,it has promoted the constant improvement of people’s living standards.With the deepening of population aging,the gradual expansion of medical insurance coverage can be seen nowadays.However,more challenges and thinking are faced though the high-speed development of medical services is promoted.As the main body of medical technology such as disease diagnosis and treatment,prevention and health care,hospitals also have to deal with the competitive relationship between hospital construction and development while ensuring their public welfare nature.Three dimensions are included for the evaluation index of Diagnosis Related Groups(DRGs),such as ability,efficiency,and safety,in which the severity and complexity of the disease are fully considered,and the consumption of medical resources is also considered.This is a combination tool that enables cases to better maintain clinical homogeneity and resource homogeneity.If the medical capacity and medical safety of a hospital are at a high level,and its time efficiency and cost efficiency are better than other hospitals,people will undoubtedly choose this hospital for treatment.The application of DRGs evaluation index by hospital can also guide hospitals to transform from scale expansion to the connotation of "increment,quality improvement,and cost reduction" in addition to motivating hospitals to strengthen medical quality management,so the high-quality development of hospitals can be realized.In this paper,Hospital Z in Zhejiang Province was selected as the research object based on the existing literature to study the current situation and countermeasures of the application of DRGs in the hospital.Firstly,based on relevant domestic and foreign literatures,the related concepts of disease diagnosis related group evaluation indicators were introduced,and the historical process of hospital performance management research based on the DRGs model and the lessons learned from previous studies were reviewed.Secondly,the data released by the hospital in 2019 and 2020,such as total DRGs,case mix index(CMI),number of difficult cases(RW≥2),time consumption index,cost consumption index,and mortality of low-risk cases were analyzed.Moreover,the changes of various indicators before and after the application of DRGs in the hospital were expounded,and the achievements of the hospital in terms of medical service quality and performance management were summarized,including the improvement of medical service capacity,the improvement of medical service efficiency,and the optimization of hospital performance management system.Problems such as low quality of medical record writing,low access rate of clinical pathway,and imperfect performance appraisal scheme occurred during the application process were analyzed.Finally,the relevant countermeasures for the application of the DRGs model to the hospital performance management were put forward based on the actual situation of the hospital and the development strategy and goals: 1)to standardize the behavior of diagnosis and treatment;2)to strengthen cost control;3)to strengthen the comprehensive competitiveness of the hospital from various aspects;4)to optimize the performance evaluation plan.