Abstract
OBJECTIVE: This study aims to assess the performance of medical services offered by tertiary general hospitals in Sichuan Province, China, by applying two comprehensive evaluation models. The findings may provide insights for policy-making and future scientific research. METHODS: Based on the diagnosis-related groups (DRGs) data, the Principal Component Analysis Modified Rank Sum Ratio (PMRSR) and Principal Component Analysis and Entropy Combined Weighted Technique for Order Preference by Similarity to an Ideal Solution Modified Rank Sum Ratio (CWTMRSR) models were developed to separately assess the medical service performance in 130 tertiary general hospitals in Sichuan Province, China. The results of the two evaluation models were compared with the head-to-tail consistency rate. RESULTS: The medical service performance of the 130 tertiary general hospitals was categorized into four groups using the PMRSR and CWTMRSR models. Among them, 86.92% were classified as "plain" and "medium", 6.15% as "poor", and 6.92% as "excellent". The number of hospitals in each group generated by both models was consistent, with 8 "poor" hospitals, 57 "plain" hospitals, 56 "medium" hospitals, and 9 "excellent" hospitals. The "excellent" hospitals identified by the two models were all Grade A tertiary general hospitals. Furthermore, the head-to-tail consistency rate of the two evaluation models was 94.23%, indicating a strong consistency between the two models. Except for the cost efficiency index (CEI) indicator, the "excellent" hospitals demonstrated superior performance on indicators such as the case-mix index (CMI), number of DRGs (ND), total weight (TW), time efficiency index (TEI), mortality of middle and low-risk groups cases (MMLRG), and standardized cases fatality rate (SCFR) compared to the "poor" hospitals. CONCLUSIONS: There are disparities in the performance of medical services offered by tertiary general hospitals in Sichuan Province, China. For hospitals categorized as "poor", there is potential for them to strengthen their management capabilities and medical techniques to retain more suitable patients while increasing their ND, TW, and CMI indicators. Furthermore, it is crucial for them to significantly elevate their quality of care to effectively reduce the MMLRG and SCFR indicators to narrow the gap with the "excellent" hospitals. The combined application of the PMRSR and CWTMRSR models can improve the reliability and stability of the medical service performance evaluation.