Research On The Construction Of Performance Evaluation Index System Of Tertiary General Hospital Based On DRG Orientation

Objective: To establish a scientific,reasonable and practical performance evaluation system for tertiary general hospitals based on the DRG orientation when the reform of DRG medical insurance collection and payment and the implementation of national public hospital performance assessment are emphasized,and apply it to the performance management of tertiary general hospitals.Promoting hospitals to adapt to the DRG medical insurance payment reform from the performance management level,promoting the high-quality development of public hospitals,and improving the fairness of hospital performance evaluation results.Methods: The characteristics of DRG evaluation index system were obtained by literature research method,expert interview method and other methods,and a DRG-based performance evaluation system model of tertiary general hospitals was constructed,and the evaluation dimensions and key performance indicators were initially determined to form a DRG-oriented three-level comprehensive hospital.Hospital evaluation index system.Using Delphi method(Delphi)to issue 3 rounds of questionnaires to selected experts for consultation,further screening to determine performance indicators;using Excel and IBM SPSS 22.0(US)software to analyze and process expert consultation data to verify the reliability of expert consultation results,and obtained the data support for the setting of index weights;the analytic hierarchy process(AHP)was used to determine the index weights,and finally a DRG-based performance evaluation index system for tertiary general hospitals was constructed.Results: This study completed the construction of the performance evaluation model of the tertiary general hospital under the guidance of DRG and the formulation of the indicator pool.The preliminary evaluation system included 3 first-level indicators,8second-level indicators,and 26 third-level indicators.The results of the expert consultation showed that the reliability and validity of the questionnaire were relatively high,and the Cronbach’s coefficient of the total items of the index system was 0.8892;the recovery rates of the questionnaires in the three rounds of correspondence were: 93.75%;93.33%;92.85%,all indicating that the experts were positive The expert authority coefficient is 0.875,indicating that the expert has a high degree of authority in this consultation;the expert coordination coefficients are: 0.302,0.315,0.323,and the P value of the significance test result is less than 0.05,indicating that the expert in this consultation The degree of coordination of opinions is good.Through three rounds of expert consultation,the selection of indicators was completed,and a DRG-oriented tertiary general hospital performance evaluation index system was determined,including3 first-level indicators,8 second-level indicators,and 27 third-level indicators.The results of the expert consultation method and the AHP showed that the indicators all passed the consistency test,CR<0,and finally determined the weight of the performance evaluation index of the third-level general hospital based on the DRG orientation.The first-level indicators "medical quality","operational efficiency"," The weights of "Sustainable Development" are: 0.4028,0.4255,and 0.1717.Conclusion: By correcting the technical difficulty differences between medical services,the work performance of different tertiary general hospitals has horizontal comparability,and the DRG performance evaluation orientation contributes to the scientificity and fairness of the evaluation results.This study derives the dimension of medical quality and operational efficiency from the DRG goal orientation.The DRG orientation combines the characteristics of tertiary general hospitals to derive the sustainable development dimension.Finally,a DRG-oriented hospital performance evaluation model is constructed,which integrates valuable traditional key performance indicators.The DRG performance indicator system has been established to provide ideas for performance management at the hospital,department,attending group and doctor levels,and work together to improve the refined management level of the hospital under the guidance of DRG.