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护理学报 ›› 2025, Vol. 32 ›› Issue (3): 22-26.doi: 10.16460/j.issn1008-9969.2025.03.022

• 护理管理 • 上一篇    下一篇

基于Ridit分析法和秩和比法的疾病诊断相关分组在护理绩效管理中的应用

李苗苗a, 熊莉娟a, 齐磊b, 李敏b, 向御婷a   

  1. 华中科技大学同济医学院附属协和医院 a.护理部; b.运营管理部,湖北 武汉 430022
  • 收稿日期:2024-10-02 发布日期:2025-03-06
  • 通讯作者: 熊莉娟（1968-）,女,湖北武汉人,本科学历,主任护师。E-mail:xhxlj@126.com
  • 作者简介:李苗苗（1990-）,女,河南周口人,硕士,主管护师。
  • 基金资助:
    华中科技大学同济医学院护理学院2023年自主创新项目（ZZCX2023X002）

Application of diagnosis-related group based on Ridit analysis and rank sum ratio method in nursing performance management

LI Miao-miaoa, XIONG Li-juana, QI Leib, LI Minb, XIANG Yu-tinga   

  1. a. Dept. of Nursing; b. Dept. of Operational Management, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
  • Received:2024-10-02 Published:2025-03-06

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摘要： 目的 探索运用护理风险指标与疾病诊断相关分组指标对科室护理绩效进行综合评价的科学性和可行性。方法 专家函询确定护理级别、导管、跌倒、血栓、压疮、自理能力共6个护理风险测评指标,2023年3-7月运用Ridit分析法测评52个科室护理风险系数,将各科室护理风险系数与疾病诊断相关分组指标纳入绩效测评体系,运用秩和比法综合评价单独使用风险系数测评的科室护理绩效顺位与纳入疾病诊断相关分组指标后的护理绩效顺位变化情况。结果 护理风险系数与病例组合指数存在不同程度的正相关;纳入病例组合指数后,科室绩效顺位正向变化20个科室,负向变化23个科室;按照秩和比法的最佳分档原则,有10个科室被划分为优秀档,35个科室被划分为良好档,7个科室被划分为一般档。无论是单独使用护理风险指标测算的科室绩效排名还是纳入病例组合指数后的科室绩效排名,重症医学科、神经外科ICU、心脏移植病区、PICU、造血干细胞移植等高风险科室护理绩效排名均在前列,与医院实际运营结果一致。结论 经评价纳入病例组合指数后的科室护理绩效排名更符合医院运营和护理工作实际,实现了护理绩效考评对病情严重、复杂程度的量化与测算,更能客观说明各科室护理绩效的差异。基于护理风险测评和疾病诊断相关分组指标的护理绩效综合评价具有客观、科学的应用价值,可为科室护理绩效分配提供借鉴。

关键词: 疾病诊断相关分组, 病例组合指数, 护理风险, 护理绩效, Ridit分析法, 秩和比法

Abstract: Objective To explore the scientificity and feasibility of nursing risk indicators and diagnosis related group (DRG) indicators to comprehensively evaluate nursing performance in various departments. Methods Nursing risk indicators were determined by expert consultations,including nursing level, catheter, fall, thrombus, pressure sore and self-care ability. Nursing risk coefficient of each department was evaluated by Ridit analysis from March to July 2023. Nursing risk coefficient and DRG indicators of each department were incorporated into the performance evaluation system. Rank sum ratio (RSR) method was applied to comprehensively evaluate the changes of nursing performance rank of departments evaluated by nursing risk coefficient alone and both nursing risk coefficient and DRG indicators. Results There was positive correlation between nursing risk coefficient and case-mix index (CMI). After CMI was included, positive changes were observed in 20 departments and negative changes in 23 departments. According to the best classification principle of RSR method, 10 departments of total 52 were rated as excellent, 35 as good, and 7 as medium. Whether using nursing risk indicators alone or incorporating CMI for departmental performance ranking, nursing performance rankings of high-risk departments such as intensive care unit (ICU), neurosurgery ICU, heart transplant unit, pediatric intensive care unit (PICU), and hematopoietic stem cell transplantation are consistently at the forefront, aligning with the actual operational results of the hospital. Conclusion Departmental nursing performance rankings with the evaluation and inclusion of CMI better reflect the actual hospital operations and nursing work, quantifying and measuring the severity and complexity of patient conditions. This approach objectively demonstrates the differences in nursing performance among departments. The comprehensive evaluation of nursing performance based on nursing risk assessment and DRG indicators is Objective and scientific and can provide insights for the allocation of departmental nursing performance.

Key words: diagnosis related group, case mix index, nursing risk, nursing performance, Ridit analysis, rank sum ratio method

中图分类号: 

  • R47
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