Abstract
BackgroundTo evaluate the performance of medical service for patients with breast cancer in Henan Province, China, using diagnosis related groups (DRGs) indicators and to provide data to inform practices and policies for the prevention and control of breast cancer.MethodsThe data were collected from the front pages of medical records (FPMR) of all hospitals above class II that admitted breast cancer patients in Henan Province between 2016 and 2019. Breast cancer patients were the subjects in our study. China DRGs (CN-DRGs) was used as a risk adjustment tool. Three indicators, including the case mix index (CMI), number of DRGs, and total weight, were used to evaluate the range of available services for patients with breast cancer, while indicators including the charge efficiency index (CEI), time efficiency index (TEI) and inpatient mortality of low-risk group cases (IMLRG) were used to evaluate medical service efficiency and medical safety.ResultsBetween 2016 and 2019, there were 103,760 patients with breast cancer. The total weight increased over the study period at an average annual rate of 21.71%. The TEI decreased over the study period by 15.60%. The CEI exhibited an increasing trend, but the average annual rate of increase was small (2.94%). The IMLRP was 0.02, 0, 0 and 0.01% in 2016, 2017, 2018 and 2019, respectively.ConclusionThe performance of medical service improved between 2016 and 2019 for breast cancer patients discharged from study hospitals in Henan Province. The main area of improvement was in the range of available services, but medical institutions must still make efforts to improve the efficiency of medical services and ensure medical safety. DRGs is an effective evaluation tool.
Highlights
To evaluate the performance of medical service for patients with breast cancer in Henan Province, China, using diagnosis related groups (DRGs) indicators and to provide data to inform practices and policies for the prevention and control of breast cancer
The Balance Score Card (BSC) method, key performance indicator (KPI) and achievement measurement method are used to evaluate the performance of hospitals, departments and doctors, respectively [5]
The diagnoses and procedures are coded according to the International Classification of Diseases, tenth revision (ICD-10) and International Classification of Diseases, Clinical Modification, 9th revision (ICD-9CM-3), respectively
Summary
To evaluate the performance of medical service for patients with breast cancer in Henan Province, China, using diagnosis related groups (DRGs) indicators and to provide data to inform practices and policies for the prevention and control of breast cancer. The BSC method provides a framework that focuses on key management processes and evaluates the realization of the vision and strategy of a hospital based on the following four dimensions: finance, customer service, internal business, and innovation [7]. The measures were designed to track performance over time and compare hospitals based on the following six dimensions: safety, patient satisfaction, efficiency, clinical quality, financial management, and medical expenses [9]. The BSC method, key performance indicator (KPI) and achievement measurement method are used to evaluate the performance of hospitals, departments and doctors, respectively [5]. Due to the inherent characteristics of medical services, including diversity, high risk, and difficulty performing comparisons, performance evaluations without risk adjustment, such as key performance indicators, cannot guarantee reliable results [13]. An evaluation tool based on risk adjustment can improve the accuracy of the evaluation results
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