Study On Comprehensive Evaluation Of Clinical Department Based On Diagnosis Related Groups

Objective: Using diagnosis related groups of related indicators,in Jiangxi province in neurology to discharge Department upload DRGs data of the hospital,a comprehensive evaluation by the Jiangxi provincial health and Family Planning Commission DRGs platform derived data,master the Department of Neurology in our province the present situation of the construction of Hospital Department of Neurology,to strengthen the fine management,specialty construction,medical service to provide reference for improving medical service performance,in order to promote the Jiangxi province key clinical specialist construction work,provide the basis for the formulation of relevant policies.Methods: According to the related indicators of disease diagnosis,the index system and the weight of the related indexes were constructed through literature research and expert panel discussion,and the weighted TOPSIS method was used to evaluate the 3 types of diseases and 3 kinds of weight combination in 29 hospitals of Jiangxi in 2016 and the K-Means clustering was used.The clustering method was used to cluster 3 diseases,and the best comprehensive evaluation scheme was determined by t test and mean maximum principle.Results: Based on the comprehensive evaluation study of DRGs neurology department:(1)the index system of comprehensive evaluation is defined as the number of case combination,the total amount of DRG,the number of DRG groups,the time consumption index,the cost consumption index,and the three different combinations of 0.45:0.25:0.1:0.1:0.1,0.35:0.35:0.1:0.1:0.1 and 0.25:0.45:0.1:0.1:0.1respectively.(2)3 kinds of classification of all diseases of Neurology,specialized diseases and national key experts were made.The number of DRG groups,the number of case combination and the total amount of DRG were statistically different(P<0.05),but there was no statistical difference between the cost consumption index and the time consumption index(P>0.05).(3)the results of the comprehensive evaluation of the 3 kinds of disease classification and the 9 models constructed by 3kinds of weight combination showed that the hospital code,A2,A6,A10,A14,A15,A16,A28,A20,accounted for the first five,which were relatively stable,but the order was slightly different.(4)the K-means clustering method was used to find out the optimal results of the 9 models: the model 9 was the comprehensive evaluation of the optimal scheme.The difference among the sorting results among the different categories was statistically significant(t=5.023,P<0.005),and the maximum difference between the two categories was 11.5721 after the cluster group TOPSIS displacement.(5)according to the comprehensive evaluation results of model 9,the hospital ranked the top 5 in neurology department of 29 Hospital of Jiangxi province in turn is A14,A18,A10,A16 and A2.Conclusion: The application of DRGs to the evaluation of medical performance is feasible.The application of DRGs index to medical performance evaluation is feasible.For hospital management,the use of DRGs indicators can be used as a good management tool to monitor and understand the management and operation of various clinical departments and the allocation of resources.It can provide a good support for the development of the subject,give full play to the construction of the specialist and make up for the more scientific guidance and strengthen the internal management of the Department.It lays a solid foundation for the fine management of hospitals.To further promote DRGs and to apply it to medical service evaluation,it is necessary to improve the quality of the data on the front page of hospitalized medical records,improve the DRGs packet,strengthen the information supervision,promote the optimization and development of the DRGs,and apply the DRGs in medical institutions to improve the medical service ability.The number of case combination,the total amount of DRG,the number of DRG,the time consumption index and the cost consumption index are the core indexes of the comprehensive evaluation of the DRGs.The TOPSIS method can make full use of the original data information to evaluate the hospital medical service performance comprehensively,and the cluster analysis is beneficial to the optimization of the comprehensive evaluation scheme.The case combination index,the total amount of DRG,the number of DRG,the time consumption index and the cost consumption index can be the core indexes of the comprehensive evaluation of DRGs,and the TOPSIS method can make full use of the original data information to evaluate the hospital medical service performancecomprehensively,and the cluster analysis is beneficial to the optimization of the comprehensive evaluation scheme.The TOPSIS evaluation method based on DRGs can reflect the medical service performance comprehensively by combining the breadth,technical difficulty and efficiency of medical service.It provides the reference direction for the hospital performance management and the development of the subject.Through adjusting and optimizing medical services to different departments,we can enhance the overall medical service level and create greater social benefits.