| Objective To compare the results of diagnosis related group system (DRGs) and traditional medical service evaluation system on the medical performance of a 3A hospital in Anhui province, so as to explore a more comprehensive and objective medical performance evaluation method for hospitals. Methods A vertical analysis between DRGs and traditional performance evaluation system was performed in evaluation of the first pages of medical records of 162 762 patients discharged from a 3A hospital in Anhui province between 2017 and 2018, and at the same time a horizontal comparison was conducted for performance evaluation in four wards of the department of orthopaedics in 2018. Results In the longitudinal comparison analysis, the results of the traditional performance evaluation system are consistent with those of the DRGs performance evaluation system in terms of efficiency evaluation. In terms of safety evaluation, the traditional performance evaluation system showed that the overall hospital mortality rate in 2018 was 0.52%, which was 0.09% lower than that in 2017. The DRGs performance evaluation system showed that the mortality rate in the low-risk group was 0.30‰ in 2018, up 0.19‰ from 2017. In terms of ability evaluation, the results of the traditional performance evaluation system showed that in 2018, the number of discharged patients, operation for discharged patients and proportion of three and four types of surgeries was 91 795, 37 155 and 68.00% respectively, an increase compared with 2017 (70 967, 27 889, 61.84%). According to the results of DRGs performance evaluation system, in 2018, the total weight and the number of DRGs groups was 82 446.85 and 669, which was improved compared with that in 2017 (64 371.85, 651). However, the proportion of RW ≥ 2 was 5.63%, and the CMI was 0.90, which decreased compared with that in 2017 (6.09%,0.91). In the transverse comparative analysis, when two evaluation systems were used to evaluate the performance of orthopaedic four wards in 2018, the performance ranking of DRGs performance evaluation system was from excellent to bad as A, B, C, D, and the performance ranking of traditional medical service evaluation system was from good to bad as A, C, B, D. Conclusion There are some differences between the two evaluation systems in evaluating hospital medical performance. In actual medical management, it should be considered to combine DRGs performance evaluation tool with traditional quality evaluation method, so as to provide effective assistance and guidance for managers to objectively understand the medical service quality and strengthen fine management. |
