醫院主管資訊系統－以診斷關聯群為例

A Framework for Developing Executive Information Systems-A Case Study of Diagnosis Related Groups Decision Support

張偉斌(Wei-Pin Chang)

《北市醫學雜誌》 6卷2期 (2009/04) Pp. 117-128

摘要

目的：醫療費用的增加已經成為全球性關注的焦點，尤其是已實施國民健康保險的國家，更為此積極尋求解決方案。健保局也因此規劃許多支付希望能有效控制上升之醫療費用；而對於醫院來說也積極要控制醫療支出的成本，因此醫院主管資訊系統即是發展用來配合醫院管理決策者的需要，運用資訊技術結合訂定醫療服務指標，來達成監控醫療服務利用及品質的管理目標，且能夠整合內、外部資訊，幫助醫院主管規劃及分析醫院之營運情形，輔助醫院主管研擬策略訂立目標，提供醫院經營管理之支援系統。方法：本文分享醫療機構建立診斷關係群系統之過程，並由主任以上層級利用線上問卷評估診斷關係群系統建立後之效果。在本研究個案醫院建置診斷關係群系統以雛形法作為系統開發方法，並搭配資料倉儲為基礎所開發之醫院主管資訊系統，系統上內容將院方主管與科別主管欲觀看的指標分為診斷關係群營運以及醫療上指標分成22項。結果：本研究結果顯示，醫療主管與行政人員皆認為(1)此系統能提供快速且正確的資訊。(2)系統畫面呈現方式是清楚。(3)系統所提供的資訊具有及時性。(4)系統介面操作上是簡要容易。結論：本研究建構了醫院主管資訊系統(HEIS)之環境，並以某區域醫院為對象，發展出能在網頁上運作，並具有各項診斷關係群指標之醫院主管資訊系統。使醫院高階主管或單位主管進行決策時，能迅速掌握關鍵資訊，提高決策的正確性，進而提升全體醫院管理績效與服務品質。

關鍵字

醫院主管資訊系統 ； 資料倉儲 ； 線上及時分析

並列摘要

Objectives: Due to the growth of medical expenses each year, Bureau of National Health Insurance proposes several optional modes of settlement to efficiently control the growing rate of medical expenses. The execution of these payment systems somehow affects the overall operation of hospitals; in the mean time, the hospitals have to maintain certain quality of medical treatment. In order to reduce cost and increase quality at the same time, and efficiently pinpoint the deficiency of hospital operation to make the correct decision, Hospital Executive Information Systems for Diagnosis Related Groups which is a support system of the management of the hospital development, created to suit the need of the policymaker to establish the indicator of medical service through its technique of integrating information, to control the use of medical service and medical quality and achieve the goal of management, and to support the executives of hospitals to institute the policy and set the goal through its integration of inner and external information. Methods: In our Hospital constructed DRGs support system through making the Prototyping the method of system development and basing on Data Warehouse to divide the indicator of operation and medical treatment into various categories (22 indicators), and integrate the website with On-line Analytical Processing (OLAP) so that the user can use the browser to observe the distribution of data under different dimension and the policymaker can gain the necessary information immediately. Results: As the research shows, (1) the executives generally think that DRGs support system can provide accurately information (63.6%) (2) the executives generally think that DRGs support system can clearly presented information (69.7%) (3) the executives generally think that DRGs support system can offer timely information (39.3%) (4) the executives generally think that DRGs support system can easily operate (48.4%). As for the management, DRGs support system enhances the medical director's ability of management in each department, and efficiently provides the information for the evaluation of hospitals. Conclusions: In this study, we construct a web-based HEIS with various functional DRGs modules. The results of the study show that HEIS can help managers to achieve important information before making decisions and thus improve the quality of their decisions.

並列關鍵字

DRGs support System ； Diagnosis Related Groups ； Data Warehouse ； Reporting System