AUTHOR=Zou Tong , Jin Yanjun , Chuang Yen-Ching , Chien Ching-Wen , Tung Tao-Hsin 

TITLE=The DEMATEL method explores the interdependent relationship structure and weights for diagnosis-related groups system

JOURNAL=Frontiers in Public Health

VOLUME=10

YEAR=2022

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2022.872434

DOI=10.3389/fpubh.2022.872434

ISSN=2296-2565

ABSTRACT=<sec><title>Purpose</title><p>This study constructs a structure of interaction between dimensions and criteria within the diagnosis-related groups (DRGs) system from a quantitative system and identifies key factors affecting the overall performance of medical services.</p></sec><sec><title>Method</title><p>From September to December 2020, the influence relation structure diagram (IRSD) of the dimensions and corresponding criteria was developed from the practical experience of a group of domain experts, based on the DEMATEL method. Subsequently, all dimensions and criteria construct influential weights from a systems perspective. Finally, the main influential factors were identified based on the analysis results.</p></sec><sec><title>Results</title><p>The IRSD results showed that, in the overall performance of medical services, “Medical service capacity (<italic>C</italic><sub>1</sub>)” was the main influential dimension, influencing both “Medical service efficiency (<italic>C</italic><sub>2</sub>)” and “Medical service safety (<italic>C</italic><sub>3</sub>).” At the criteria level, “Case-mix index (CMI) (<italic>C</italic><sub>12</sub>),” “Time efficiency index (C<sub>21</sub>),” and “Inpatient mortality of medium-to-low group (C<sub>32</sub>)” were the main influential criteria in the corresponding dimensions. The influential weight results showed that “Medical service capacity (<italic>C</italic><sub>1</sub>)” was also a key dimension. “Case-mix index (CMI) (<italic>C</italic><sub>12</sub>),” “Cost efficiency index (<italic>C</italic><sub>22</sub>),” and “Inpatient mortality of medium-to-low group (<italic>C</italic><sub>32</sub>)” were the key criteria in their respective dimensions.</p></sec><sec><title>Conclusion</title><p>Patients and managers should first focus on the capacity of medical service providers when making a choice or deciding using the results of the DRGs system. Furthermore, they should pay more attention to medical safety even if it is not as weighted as medical efficiency.</p></sec>