Research on the Construction of the Hospital"Three in One"Quality Control System Suitable for DRG Payment
- VernacularTitle:与DRG付费相适应的医院"三全"质控体系构建探索
- Author:
Xiujuan DAN
1
;
Lijia ZHANG
;
Likun MIAO
;
Cong WANG
;
Yu CHEN
;
Tianran LI
;
Xiaowei SUN
;
Kun PENG
Author Information
1. 解放军总医院第四医学中心卫生经济科 北京 100048
- Publication Type:Journal Article
- Keywords:
Diagnosis Related Group;
whole basin data source;
whole process quality control;
whole dimensional intelligent supervision
- From:
Chinese Health Economics
2024;43(12):99-104
- CountryChina
- Language:Chinese
-
Abstract:
Objective:Construct the hospital"three in one"quality control system suitable for medical insurance DRG payment,and realize the safe,stable and efficient operation of medical insurance DRG actual payment. Methods:By using data aggregation and fusion technology,through standardized governance of data across the entire basin,optimization of the entire process quality control system and comprehensive intelligent quality control system management,the visualization and interactive analysis of data could be achieved,thereby improving the precision support of hospital operation efficiency. Results:After actual operation,the disease enrollment rate reached to 99％,the Case Mix Index (CMI) boosted from 0.96 to 1.32,the average length of hospital stay decreased by 1.07 days,the time consumption index and the cost consumption index both fell below 1. The supervision method extended from manual sampling to intelligent quality control,the supervision process extended from a fixed process to a dynamic process and the focus of supervision extends from the review of the settlement list to the supervision of medical behavior. Conclusion:Construct the hospital"three in one"quality control system is a necessary way to promote DRG paying medical institutions to enter the fast lane of standardization,collaboration and refined management,which made a beneficial attempt for the practical application of DRG payment in hospitals.
