摘要
目的系统评价我国基于疾病诊断相关分组(diagnosis-related group,DRG)进行住院服务绩效综合评价的研究方法,为后续相关方法的改进与完善提供参考。方法检索中国知网、万方、维普和PubMed数据库,检索时间从建库至2019年5月,获取基于DRG进行综合绩效评价的研究。由2名研究者独立筛选文献并提取综合评价方法相关资料,定性分析并描述综合评价方法在基于DRG的医疗服务绩效评价中的运用情况。结果系统评价共纳入24篇文献,各研究基于评价目的对DRG指标的选用有所不同。8篇文献通过德尔菲法、专家讨论法、Saaty法或其他方法确定了指标权重。9篇研究使用秩和比法、7篇研究使用逼近理想解排序法、9篇研究使用综合指数法进行绩效评价,层次分析法、组合评价法亦有应用。结论纳入研究基于DRG,对医疗服务绩效评价指标选用、权重确定、综合评价值计算进行了不同程度的探索,后续研究应着重于权重的科学使用,深入探索组合评价法,并注重信息源的质量和评价结果的科学应用。
Objective To systematically review the comprehensive evaluation methods applied to estimate the medical service performance based on diagnosis-related groups(DRGs) in China and to provide suggestions for the promotion of methods in further studies. Methods Literature published before May 2019 were searched in China National Knowledge Infrastructure, WanFang Data, CQVIP and PubMed for studies about DRGs-based comprehensive evaluation. After literature screening and information extracting by two reviewers independently, qualitative approaches were used to describe the application of DRGs-based comprehensive evaluation methods in the performance evaluation of medical services. Results A total of 24 articles were included in the systematic review. Different indexes were used to evaluate the medical service performance. Delphi Method, expert discussion, Saaty’s Method and some other means were applied to determine the weights of indexes in 8 articles. Rank-sum ratio method, Technique for Order Preference by Similarity to an Ideal Solution and synthetic index method were proposed for the comprehensive evaluation in9, 7 and 9 articles, respectively;besides, analytic hierarchy process and combination evaluation were also used.Conclusions Based on DRGs, the choose of indicators, weighting approaches, and calculation methods of comprehensive values vary richly in different studies. More attention should be paid to weight using and combination of comprehensive evaluation methods in further studies. Meanwhile, the quality of information source used for estimation and the rationality of results application are supposed to be emphasized.
作者
郑雪
陈平
邓清华
王苑
李璐
ZHENG Xue;CHEN Ping;DENG Qinghua;WANG Yuan;LI Lu(Department of Quality Control,Affiliated Hospital of Southwest Medical University,Luzhou,Sichuan 646000,P.R.China)
出处
《华西医学》
CAS
2019年第12期1384-1389,共6页
West China Medical Journal
基金
西南医科大学附属医院管理类项目(2017-GL-7)
关键词
综合评价方法
绩效评价
疾病诊断相关分组
系统评价
Comprehensive evaluation method
Performance evaluation
Diagnosis-related groups
Systematic review
