Construction of DRG Implementation Effect Evaluation Index System from the Perspective of Hospital,In-surance and Patients
- VernacularTitle:医保患视角下DRG实施效果评价指标体系构建研究
- Author:
Lüfan FENG
1
;
Jiajie XU
;
Mi TANG
;
Ying PENG
;
Chunlin JIN
Author Information
1. 上海市卫生和健康发展研究中心·上海市医学科学技术情报研究所 上海 200031
- Publication Type:Journal Article
- Keywords:
DRG;
implementation effect;
evaluate index system
- From:
Chinese Hospital Management
2025;45(3):72-77
- CountryChina
- Language:Chinese
-
Abstract:
Objective To construct the evaluation index system of DRG implementation effect from the interests of medical insurance,hospitals and patients,and provide evaluation tools for medical insurance departments to grasp the actual operation effect of DRG.Methods The evaluation index system is constructed initially through literature re-view,and then Delphi method is used to conduct two rounds of expert consultation.According to the concentration degree and coordination degree of expert opinions,the index system is selected and modified,and the final evalua-tion index system is constructed.Results The positive coefficients of experts in the two rounds of expert consultation were 73%and 82%respectively,and the average authority coefficient of experts was 0.78.In the second round of consultation,the Kendell's W coefficients of the importance,data availability and sensitivity of the evaluation index were 0.517,0.437 and 0.472 respectively(P＜0.001).Finally,the evaluation index system of DRG implementation effect includes 3 first-level indicators,9 second-level indicators and 29 third-level indicators.Conclusion The evalua-tion index system of DRG implementation effect has high enthusiasm of experts,good authority,coordination and concentration of experts,which can be used to evaluate the sustainability of medical insurance fund,the service out-put of medical institutions and the rights and interests of patients in DRG pilot areas.
