Performance assessment of the inpatient medical services of a clinical subspecialty

Abstract

Diagnosis-related groups (DRGs) have been receiving increasing attention in health service research in China. In the present study, we used the 2014 Beijing-Diagnosis Related Groups (BJ-DRGs) to evaluate the inpatient service performance of the clinical subspecialty “major operation of the digestive system” of a cancer specialist hospital.The research hospital is one of 16 public municipal hospitals overseen by the Beijing Health Bureau (“16 hospitals”). Discharge data collected between 2008 and 2015 were drawn from the front pages of the medical records of these hospitals. After the data were reported to the Beijing Public Health Information Centre, as well as being grouped using the BJ-DRGs. We evaluated the service performance of this subspecialty in terms of capacity, efficiency, and service quality, based on the BJ-DRGs risk adjustment tool.From 2008 to 2015, the total weight of the subspecialty in the research hospital increased annually. In 2015, the cases in this hospital accounted for 50.27% of the total in 16 hospitals. The time consumption index was 0.91, whereas the charge consumption index was 1.24, which was 24% higher than the average in16 hospitals. The mortality rates of the middle–low risk groups (GB15 and GB25) in the research hospital and the 16 hospitals were zero, while the mortality rates for the middle–high risk groups (GB11 and GB23) in the research hospital were significantly lower than those in 16 hospitals.The service capacity of the subspecialty steadily increased in the research hospital. However, the hospital must offer more attention to complex digestive disease cases (GB11/GB23) and strictly control hospitalization expenses, while maintaining the advantages of service efficiency and quality.

Effective Analysis of Inpatient Satisfaction: The Random Forest Algorithm

“…The economic burden of hospitalized patients has been further reduced with the introduction of the Chinese version of DRG-grouping standards and the establishment of key clinical pathways. 49 , 50 However, the expectation of patient satisfaction may lead to the breakdown of hospitalization system, which can accelerate the adverse selection of patients in public hospitals. Therefore, to improve their motivation at work, medical workers should improve the scale economic benefits of public hospitals by establishing corresponding incentive mechanisms in the implementation of various management tools.…”

Impact of the Global Budget Payment System on Expenditure of Cardiovascular Diseases: An Interrupted Time Series Analysis in Shanghai, China

“…In that case, the impact of the GBPS in Shanghai provides reference to other provinces in China which launched the GBPS recent years [22]. Recently, the Chinese government tried mixed payment system launch, such as diagnosis related groups (DRGs), which were also on the base of the GBPS [23,24].…”

Impact of DRGs-based inpatient service management on the performance of regional inpatient services in Shanghai, China: an interrupted time series study, 2013–2019

“…In addition, the medical expenses, length of stay, mortality and other data of each case were collected to calculate performance indicators which could be reported monthly, quarterly and annually. So through the ISMS, we collected quarterly data, from 2013 to 2019, of 7 DRGs-based performance measures [ 19 , 20 ] including the capacity dimension (DRGs number, case-mix index (CMI), total weight), efficiency dimension (time efficiency index (TEI), cost efficiency index (CEI)), quality dimension (inpatient mortality of low-risk group cases (IMLRG), inpatient mortality of medium-to-low risk group cases (IMMLRG)).…”