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

Area of Science:

• Healthcare Management
• Health Services Research
• Quantitative Analysis

Background:

• The Diagnosis-Related Groups (DRGs) system is a critical framework for classifying hospital cases and managing healthcare services.
• Understanding the interdependencies between different dimensions and criteria within the DRGs system is essential for optimizing overall medical service performance.
• Existing research often analyzes DRGs components in isolation, necessitating a systems-level approach to identify key influencing factors.

Purpose of the Study:

• To construct an interaction structure between dimensions and criteria within the DRGs system using a quantitative approach.
• To identify key factors that significantly affect the overall performance of medical services under the DRGs framework.
• To determine the influential weights of various dimensions and criteria from a systems perspective.

Main Methods:

• Utilized the Decision-Making Trial and Evaluation Laboratory (DEMATEL) method to develop an Influence Relation Structure Diagram (IRSD).
• Collected data and insights from domain experts between September and December 2020.
• Analyzed the IRSD and influential weights to identify the primary drivers of medical service performance.

Main Results:

• "Medical service capacity (C1)" was identified as the most influential dimension, impacting both "Medical service efficiency (C2)" and "Medical service safety (C3)".
• Key influential criteria included "Case-mix index (CMI) (C12)", "Time efficiency index (C21)", and "Inpatient mortality of medium-to-low group (C32)".
• The influential weight analysis reinforced "Medical service capacity (C1)" as a key dimension, with "Case-mix index (CMI) (C12)", "Cost efficiency index (C22)", and "Inpatient mortality of medium-to-low group (C32)" as critical criteria.

Conclusions:

• Healthcare providers and managers should prioritize "Medical service capacity" when utilizing DRGs system outputs.
• Greater attention should be directed towards "Medical service safety", even when "Medical service efficiency" appears to have a higher weight.
• The findings provide actionable insights for improving healthcare management and resource allocation within DRGs-based systems.