Performance Measurement for Clinical Departments Using Drg-Dea : A Case Study

ObjectiveTo explore the comprehensive measurement and full ranking of inpatient service performance in clinical departments.MethodsA total of 22 588 discharged cases were collected from 24 clinical departments of a tertiary hospital in Fujian province of China in 2022. A recently proposed DEA model was employed to process positive, zero and negative data and fully rank. The data set was divided into two sets in terms of whether adjustments were made to outputs using DRG classifications and a case mix index (CMI), and both sets used the same inputs. Set 1 used discharges, average length of stay (ALOS), average charges and inpatient deaths as outputs, while Set 2 used adjusted discharges, adjusted time efficiency index (aTEI), adjusted charge efficiency index (aCEI) and inpatient deaths of low-risk groups (IDLRG) with risk adjustment as outputs. Finally, the results were analysed and tested statistically.ResultsThe mean efficiency of Set 1 was 0.674 with 9 (37.5%) DEA-efficient DMUs, while the mean efficiency of Set 2 was 1.021 with 18 (75%) DEA-efficient DMUs. The Wilcoxon paired sign rank test of DMUs’ efficiency scores between the two sets showed a significant difference (p<.001).ConclusionThe proposed DRG-DEA model in this study takes a patient-centric view and conducts comprehensive measurement and full ranking from the perspectives of capacity, efficiency and quality, to help managers improve health care performance. The recent DEA (Lee) model to handle positive, zero and negative data performs well in this hospital setting in terms of ranking the DMUs when comparing the two data sets