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学科主题: 公共卫生
题名:
Performance evaluation of inpatient service in Beijing: a horizontal comparison with risk adjustment based on Diagnosis Related Groups
作者: Jian, Weiyan1; Huang, Yinmin1; Hu, Mu2; Zhang, Xiumei3
刊名: BMC HEALTH SERVICES RESEARCH
发表日期: 2009-04-30
DOI: 10.1186/1472-6963-9-72
卷: 9
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Health Care Sciences & Services
研究领域[WOS]: Health Care Sciences & Services
关键词[WOS]: CARE
英文摘要:

Background: The medical performance evaluation, which provides a basis for rational decision-making, is an important part of medical service research. Current progress with health services reform in China is far from satisfactory, without sufficient regulation. To achieve better progress, an effective tool for evaluating medical performance needs to be established. In view of this, this study attempted to develop such a tool appropriate for the Chinese context.

Methods: Data was collected from the front pages of medical records (FPMR) of all large general public hospitals (21 hospitals) in the third and fourth quarter of 2007. Locally developed Diagnosis Related Groups (DRGs) were introduced as a tool for risk adjustment and performance evaluation indicators were established: Charge Efficiency Index (CEI), Time Efficiency Index (TEI) and inpatient mortality of low-risk group cases (IMLRG), to reflect respectively work efficiency and medical service quality. Using these indicators, the inpatient services′ performance was horizontally compared among hospitals. Case-mix Index (CMI) was used to adjust efficiency indices and then produce adjusted CEI (aCEI) and adjusted TEI (aTEI). Poisson distribution analysis was used to test the statistical significance of the IMLRG differences between different hospitals.

Results: Using the aCEI, aTEI and IMLRG scores for the 21 hospitals, Hospital A and C had relatively good overall performance because their medical charges were lower, LOS shorter and IMLRG smaller. The performance of Hospital P and Q was the worst due to their relatively high charge level, long LOS and high IMLRG. Various performance problems also existed in the other hospitals.

Conclusion: It is possible to develop an accurate and easy to run performance evaluation system using Case-Mix as the tool for risk adjustment, choosing indicators close to consumers and managers, and utilizing routine report forms as the basic information source. To keep such a system running effectively, it is necessary to improve the reliability of clinical information and the risk-adjustment ability of Case-Mix.

语种: 英语
项目资助者: Beijing Health Bureau
WOS记录号: WOS:000266691300001
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/57318
Appears in Collections:北京大学公共卫生学院_期刊论文

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作者单位: 1.Peking Univ, Hlth Sci Ctr, Sch Publ Hlth, Beijing, Peoples R China
2.Peking Univ, Hlth Insurance Off, Med Sch 3, Beijing, Peoples R China
3.Beijing Publ Hlth Informat Ctr, Beijing, Peoples R China

Recommended Citation:
Jian, Weiyan,Huang, Yinmin,Hu, Mu,et al. Performance evaluation of inpatient service in Beijing: a horizontal comparison with risk adjustment based on Diagnosis Related Groups[J]. BMC HEALTH SERVICES RESEARCH,2009,9.
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