目的:分析2015年至2020年某院住院死亡病例特点.方法:选取我院2015年至2020年住院死亡患者的各项资料,并应用《国际疾病分类》ICD-10分类其出院诊断结果,通过SPSS22.0统计学软件对住院死亡患者的男女比例、各年份死亡情况、年龄构成情况与死因进行整理、分析.结果:2015年～2020年期间共有123105例患者于我院接受住院治疗,其中死亡患者2508例,病死率为2.04％.2508例死亡患者中,男性死亡率高于女性(P<0.05).2508例死亡患者中,1～9岁患儿死亡率最低,为1.56％,而50～59岁患者死亡率最高,达到19.54％,在30岁开始患者的死亡率逐渐升高,我院2015年至2020年住院患者死因顺位排序显示,1523例(60.73％)患者因损伤、中毒死亡,居于第一位;414例(16.51％)患者因循环系统疾病死亡,居于第二位;325例(12.96％)患者因肿瘤死亡,居于第三位.结论:2015年至2020年住院死亡患者的死亡率呈逐年下降趋势,其中男性50～59岁患者死亡率较高,损伤、重度与循环系统疾病等均是患者死亡的主要诱因.

新型冠状病毒肺炎,是指2019新型冠状病毒感染导致的肺炎.新型冠状病毒肺炎U07.100x001适用于新型冠状病毒肺炎的确诊患者;新型冠状病毒肺炎临床确诊病例U07.100x003适用于第五版诊疗方案中湖北等地的临床诊断病例;新型冠状病毒感染U07.100x002适用于新型冠状病毒无症状感染者.不忽视新型冠状病毒肺炎疑似病例作为其它诊断代码的作用.明确新冠肺炎临床分型,细读病案,准确完整地编码出该病案的其它诊断、手术和相关操作.编码员应重视新型传染病ICD编码工作,了解编码的分类原则,结合临床诊疗方案,仔细阅读病案相关内容,明确临床诊断和临床分型,提高编码准确性.

Objectives To investigate the evaluation of the medical service performance of the hospital based the diagnosis related group (DRGs) in technique for order preference by similarity to an ideal solution statistics method. Methods The front page information of patients from a hospital in Beijing were analyzed by the Beijing edition of the diagnosis related group (BJ-DRGs), then the DRGS related information of patients were obtained. The TOPSIS statistics method was applied to analyze the medical service performance of hospital. Results The hospital treated disease categories (MDC) was 23 groups, DRGs group was 522, case mix index (CMI) was 0.95, which was close to the average level of medical technology difficulty in Beijing; cost index, time consumption index were 1.09, 1.11, which were cower than the average level of the service efficiency. The department of most widely used in the treatment of disease was the department of general surgery, the DRGS group was about 130 group, The difficulty of treatment was the department of Cardiology, CCU and department of Neurosurgery, the case mix index was 1.39. The time and pay consumption index of department of urology surgery was the lowest, but the longest was obstetrics and gynecology department. The result of TOPSIS showed the department with best medical service performance were department of cardiology, department of orthopedics, department of general surgery, department of infectious disease, department of oncology, respectively as top 5, the medical service performance of the department of renal medicine, obstetrics, gynecology, of endocrinology, department of urology were lowest respectively. Conclusion The TOPSIS evaluation method based on the DRGs utilized comprehensively the width and difficulty of the medical service, the medical service efficiency index, the evaluation result was objective and reliable, it provided a reasonable and feasible method for the hospital medical performance evaluation.

目的 探讨基于疾病诊断相关组(DRGs)对医疗服务绩效进行秩和比法(RSR)评价.方法 利用北京市某三甲医院2015年上半年出院患者的首页信息,通过“北京版诊断相关组(BJ-DRGs)”的病例组合系统分析获取出院患者的DRGs相关信息,运用RSR评价方法对各科室医疗服务进行综合绩效评价.结果 1)全院收治疾病大类(MDC)组数为23组,DRGs组数为479组,病例组合指数(CMI)为0.96,接近北京市医疗技术难度的平均水平;费用消耗指数、时间消耗指数分别为1.06、1.07,高于北京市服务效率的平均水平.2)治疗疾病范围最广的是传染科,DRGs组数71个;技术难度最高的为危重症内科部ICU,CMI指数为3.17;泌尿外科的住院时间消耗最短、费用消耗最低;妇产科的住院时间消耗最长、费用消耗最大(1.28,1.46).3)RSR综合评价显示,最优档为传染科、神经内科、泌尿外科、中西医结合科、ICU;最差档为妇产科、儿科.结论 基于DRGs的RSR评价方法,综合了医疗服务广度及难度、医疗服务效率指标,评价结果客观,为医院绩效评价提供了一种可行的方法.