DRG Payment Surgical Departments OperatingEfficiency Influence Factors
福建省医药卫生体制改革研究会2022年度第二批卫生健康政策创新研究课题基金资助（2022C01）
目的：研究某三级综合性医院外科DRG支付方式前后运行效率的变化情况，为DRG支付方式下医院临床科室精细化管理提供思路。方法：收集2019-2021年某三级综合性医院外科运行数据指标，先运用数据包络分析法（DEA）的BCC和Malmquist模型进行分析，再采用tobit回归进行影响因素分析。结果：DRG支付方式改革后外科全要素生产率为1.144，其中技术变动指数为1.149。CMI值、病床周转次数与外科运行效率呈正相关，实际开放床位、固定资产、DRG组数与外科运行效率呈负相关，其中CMI值相关性较大。结论：DRG支付方式可推动临床科室通过精细化管理、技术进步提升科室运行效率。医院可根据自身发展需要，分类探索最适宜的DRG相关指标纳入效率评价体系，引导高质量发展。
Objective：To study the changes of the operation efficiency of surgery departments before and after the DRG（diagnosis related groups）payment in a certaintertiary general hospital，and to provide ideas for the fine management of hospital clinical departments under the background of DRG payment. Methods：The operational data of surgical departments in a certain tertiarygeneral hospital from 2019 to 2021 were collected. TheBCC and Malmquist models of data envelopment analysis（DEA）were used for analysis，and the influencing factors were analyzed by Tobit regression. Results：The total factor productivity of surgical departments after DRG payment reform was 1.144，and the technical change index was 1.149. CMI value and number of hospital bed turnover are positively correlated with operation efficiency，while actual open beds，fixed assets and number of DRG groups are negatively correlated with operation efficiency，CMI value is highly correlated. Conclusion：DRG payment can promote the operation efficiency of clinical departments through fine management and technological progress. According to development needs，hospitals can categorically explore the most appropriate DRG-related indicators to be included in the efficiency evaluation system，so as to guide high-quality development.