[1]任晋文,朱佳英,朱 艺.DRG纳入医院绩效考核对住院服务水平的影响 ——基于中断时间序列分析[J].卫生经济研究,2025,42(08):65-68,74.
　REN Jinwen,ZHU Jiaying,ZHU Yi.Impact of DRG Incorporated into Hospital Performance Evaluation on Inpatient Service Quality ——Based on Interrupted Time Series Analysis[J].Journal Press of Health Economics Research,2025,42(08):65-68,74.
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DRG纳入医院绩效考核对住院服务水平的影响
——基于中断时间序列分析

卫生经济研究[ISSN:1004-7778/CN:33-1056/F]

卷:
42
期数:
2025年08期
页码:
65-68,74
栏目:
卫生服务利用
出版日期:
2025-07-31

文章信息/Info

Title:
Impact of DRG Incorporated into Hospital Performance Evaluation on Inpatient Service Quality
——Based on Interrupted Time Series Analysis
作者:
任晋文1; 朱佳英1; 朱 艺1
1.浙江省人民医院（附属人民医院），杭州医学院，浙江 杭州 310014
Author(s):
REN Jinwen;  ZHU Jiaying;  ZHU Yi
Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou Zhejiang 310014, China
关键词:
DRG; 绩效考核; 中断时间序列分析; 住院服务水平
Keywords:
DRG;  performance evaluation;  interrupted time series analysis;  inpatient service quality
分类号:
F840.684
文献标志码:
A
摘要:
目的：分析DRG纳入医院绩效考核对住院服务水平的动态影响，为深化医保支付方式改革提供实证参考。方法：以浙江省某三甲医院348 508份病例数据为研究对象，采用中断时间序列分析法，结合三级协同治理框架下的技术赋能和差异化激励机制，系统评估住院服务水平变化。结果：DRG纳入医院绩效考核后，医院基础病组占比下降，CMI值与四级手术占比提升，病组结构优化；次均住院费用、时间消耗指数、费用消耗指数降低，费用控制与诊疗效率提升；药品与材料费用占比持续下降，但体现技术价值的治疗费用改善有限。结论：DRG与医院绩效考核协同机制有效破解了改革政策“上热下冷”的执行困境，但需配套医疗服务价格调整与动态监管政策，才能真正实现医院成本控制与技术价值提升的双重目标。
Abstract:
Objective To analyze the dynamic impact of DRG incorporated into hospital performance evaluation on inpatient service quality, and to provide empirical references for deepening the reform of health insurance payment method. Methods Using 348 508 case data from a tertiary hospital in Zhejiang Province as the study object, interrupted time series analysis was used to systematically evaluate the changes in inpatient services by combining technology empowerment and differentiated incentive mechanism under the three-level collaborative governance framework. Results After DRG was incorporated into hospital performance evaluation, the proportion of basic disease groups in the hospital declined, the proportion of CMI values and fourth level surgeries increased, and the structure of disease groups was optimized. The average hospitalization cost, time consumption index, and cost consumption index decreased, and cost control and diagnostic and therapeutic efficiency were improved. The proportion of drug and material costs continued to decline, but the improvement of treatment costs reflecting the value of technology was limited. Conclusion The synergistic mechanism of DRG and hospital performance evaluation has effectively solved the implementation dilemma of "hot at the top and cold at the bottom" in the reform policy. However, it needs to be complemented with the policy of medical service price adjustment and dynamic supervision, so as to truly realize the dual goals of cost control and technical value enhancement of hospitals.

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更新日期/Last Update: 2025-07-31