摘要
目的为顺应DIP付费变革下的新形势,本文以荆州市某公立三甲综合医院为例,以病种分析为切入点,探索精细化运营管理策略,促进医院发展转型升级与运营效率的提升。方法2022年7月起,以问题为导向,利用波士顿矩阵模型、柏拉图、“剥洋葱法”等方法深入分析病种结构特征,采取多学科运营管理模式,有针对性督导科室完善诊疗流程,优化病种及费用结构等,对科室实施精细化管理。结果样本科室医疗服务能力不断增长,病种数量同比增长5.76%,出院人次同比增长20.9%,DIP去药耗CMI值上升0.22;经济结构明显优化,住院均次药品费用下降14.19%,住院均次材料费用下降30.62%;医保结算大幅改善,医保亏损减少80%以上;运营效率显著提升,平均住院日同比下降1.0天;患者就医体验改善,患者满意度达97%以上。结论DIP背景下基于病种分析的精细化运营管理模式能够促进医院高效运行、医保基金合理使用、患者负担有效降低的多方共赢局面的形成。
Objective In response to the new landscape of the DIP payment reform,this study uses a public tertiary comprehensive hospital in Jingzhou as a case study.By focusing on disease analysis,it explores refined operational management strategies to promote the hospital′s transformation,upgrade,and operational efficiency.Methods Starting from July 2022,a problem-oriented approach was employed to analyze the characteristics of disease structure using methods such as the Boston Matrix,Pareto Analysis,and the Onion Method.A multidisciplinary operational management model was adopted to provide targeted supervision to departments for improving diagnosis and treatment processes,optimizing disease types and cost structures,and implementing refined management.Results The sample departments showed continuous growth in medical service capabilities,with the number of disease types increasing by 5.76%year-on-year and the number of discharges rising by 20.9%.The CMI value for DIP-related drug consumption increased by 0.22.The economic structure improved significantly,with average drug costs per inpatient decreasing by 14.19%and average material costs dropping by 30.62%.Medical insurance settlements saw substantial improvement,with losses reduced by over 80%.Operational efficiency was notably enhanced,with the average length of stay decreasing by 1.0 days year-on-year.Patient experience improved,with satisfaction rates exceeding 97%.Conclusion The refined operational management model based on disease analysis under the DIP framework can facilitate efficient hospital operations,promote rational use of medical insurance funds,and effectively reduce patient burdens,leading to a win-win situation for all stakeholders.
作者
王新伟
朱宁
陈顺琴
杨清晨
WANG Xinwei;ZHU Ning;CHEN Shunqin;YANG Qingchen(The First Affiliated Hospital of Yangtze University/The First People′s Hospital of Jingzhou,Jingzhou 434000,China)
出处
《现代医院》
2024年第10期1579-1583,共5页
Modern Hospitals
关键词
DIP
病种分析
精细化
多学科运营
DIP
Disease analysis
Refinement
Multidisciplinary operation
