目的 探讨团体体检据实结算的方法，提高体检中心接检人员的工作效率和质量。 方法 采用六西格玛法, 并通过其定义、测量、分析、改进、控制5个步骤，研究并改进团体据实结算的方法，同时对比分析方法改进前后，“清理分检未完”的单次工作量、单次制表时间、单次核实时间以及缺陷发生率。 结果 方法改进后，“清理分检未完”的单次工作量变化无统计学意义（P＞0.05）；单次制表时间由（4.23 ± 0.43）h缩短至（0.06 ± 0.01）h、单次核实时间由（3.18 ± 0.46） h缩短至（1.07 ± 0.01）h、缺陷率从4.83%降至0.69%（P＜0.01）,达到了预期目标。 结论 运用六西格玛法可以发现流程中存在的关键问题,从而提出有针对性的改进措施,提高工作效率和质量。
Taking the Breast Surgery Department of the Second Affiliated Hospital Zhejiang University School of Medicine as an example, this paper introduces the quality management experience of day surgery case settlement checklist. Through the establishment of diagnosis-related groups (DRGs) settlement checklist quality control review mechanism, the introduction of DRGs information system to monitor the quality of settlement checklist in real time, and strengthening the supervision of low-rate cases and other measures, the quality of medical insurance fund settlement checklist and the accuracy of case enrollment have been effectively improved, and the occurrence of low-rate cases has been reduced. On the whole, day surgery and DRGs payment jointly promote the effective improvement of medical service efficiency and the reasonable allocation of medical resources, and reduce the average cost per patient and the average length of hospital stay.