梳理了疾病诊断相分组（DRG）支付背景下医院所面临医疗行为变化风险、新技术和新业务开展的风险、病案质量下降风险、信息化风险和护理质量下降风险等一系列风险与挑战。通过对运用绩效管理手段应对风险与挑战的战略分析，提出了构建基于DRG的综合绩效考核体系和医院、科室、医疗组和医生四维一体的DRG综合绩效评价分析和反馈体系、建立DRG支付下的新技术和新业务绩效激励机制、强化病案质控审核和加大病案质量绩效奖惩力度、开发和维护基于DRG的绩效核算与分配信息系统、建立以护理工作量和质量并重的护理人员绩效考核体系等应对措施。

This paper reviews the basic concepts of disease diagnosis phase grouping（DRG），and points out a series of risks and challenges faced by hospitals under the background of DRG payment，such as the risk of medical behavior change，the risk of new technology and new business development，the risk of medical record quality decline，the risk of information technology and the risk of nursing quality decline. Through the strategic analysis of the use of performance management tools to cope with risks and challenges，it is proposed to construct a comprehensive performance evaluation system based on DRG and a DRG comprehensive performance evaluation analysis and feedback system integrating hospitals，departments，medical groups and doctors，establish a new technology and new business performance incentive mechanism under DRG payment，strengthen the quality control review of medical records and increase the rewards and punishments of medical records quality performance，develop and maintain the performance accounting and distribution information system based on DRG，and establish a performance evaluation system for nursing staff with equal emphasis on nursing workload and quality.