Jian Wei-yan, Cui Tao, Wang Hong-yuan, Hu Mu, Huang Yin-min, Zhang Xiu-mei, Guo Yan
Department of Health Policy and Management, Peking University School of Public Health, Beijing 100083, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2007 Apr 18;39(2):145-8.
To introduce diagnosis related groups to assess the medical quality and try to establish an effective quality evaluation approach.
Using Australia-Refined Diagnosis Related Groups, version 5.0 (AR-DRGs v5.0) to classify the 160 000 discharged cases from 7 large hospitals in Beijing in 2005. Based on this, mortality risk classification was established to adjust the whole-hospital risks. And then hospital mortality of all the risk groups from each hospital was calculated respectively, which was used as the basic quality assessment criterion. The differences between the assessment results from using the raw hospital mortality and from using Diagnosis Relative Groups Mortality Risk Classification (DRGs-MRC) were compared.
(1) The risk types were different among the discharged cases in different hospitals; (2) The assessment results from these two approaches about No.6 hospital were similar in that No.6 hospital had a good quality performance; (3) The raw hospital mortality was the lowest in No.2 hospital (0.98%), but the mortality of low risk group in this hospital was higher than the average level of the same risk group among these 7 hospitals; the status of No.5 hospital was much the same.
Compared with raw hospital mortality, DRGs-MRC improved the comparability of cases and the reliability of the assessment result.
引入诊断相关分组以评估医疗质量，并尝试建立有效的质量评估方法。
采用澳大利亚精细化诊断相关分组第5.0版（AR-DRGs v5.0）对2005年北京7家大型医院的16万例出院病例进行分类。在此基础上，建立死亡风险分类以调整全院风险。然后分别计算各医院所有风险组的医院死亡率，将其作为基本质量评估标准。比较使用原始医院死亡率和使用诊断相关分组死亡风险分类（DRGs-MRC）的评估结果之间的差异。
（1）不同医院出院病例的风险类型不同；（2）这两种方法对6号医院的评估结果相似，即6号医院质量表现良好；（3）2号医院的原始医院死亡率最低（0.98%），但其低风险组的死亡率高于这7家医院中同风险组的平均水平；5号医院情况大致相同。
与原始医院死亡率相比，DRGs-MRC提高了病例的可比性和评估结果的可靠性。
