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DRG支付下某院恶性增生性疾患分组效果与住院费用分析
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| 篇名： | DRG支付下某院恶性增生性疾患分组效果与住院费用分析 |
| TITLE： | Analysis of the grouping effect and hospitalization cost of patients with malignant proliferative disease in a hospital under DRG payment |
| 摘要： | 目的 分析某医院疾病诊断相关分组（DRG）支付下恶性增生性疾患的分组效果与住院费用构成及变动情况，为医疗机构改进DRG付费相关措施、控制药品费用以及有关部门制定相关决策提供依据。方法收集某“三甲”综合医院2021、2022年的恶性增生性疾患住院病例信息，使用变异系数（CV）对DRG分组效能进行评价，结合结构变动度与新灰色关联分析法研究住院费用的结构变动及其与各项费用间的关联程度。结果恶性增生性疾患DRG病组总体变异降低系数（RIV）为79.36%，除RW21病组CV为1.09外其他病组CV均小于1；相比于2021年，2022年恶性增生性疾患的次均住院费用下降了17.80%，管理费、药品费的降幅分别为32.15%、21.30%，医疗费的增幅为17.26%；药品费的新灰色关联度降低，但医疗费的新灰色关联度升高。结论DRG支付下样本医院恶性增生性疾患住院费用下降，但RW21等病组的分组效能有待提升，费用结构有待优化。 |
| ABSTRACT： | OBJECTIVE To analyze the grouping effect and composition of hospitalization costs for cases of patients with malignant proliferative disease under the diagnosis-related group （DRG） payment system， as well as any changes， in order to provide a basis for medical institutions to improve DRG payment-related measures， control drug costs， and for relevant departments to make decisions. METHODS The data of patients with malignant proliferative disease cases were collected from a “Third Grade Class A” hospital in 2021 and 2022， and the variation coefficient （CV） was used to evaluate the grouping of DRG. The structural variation degree and the new grey correlation analysis were used to study the structural variation of hospitalization cost and the correlation degree between the hospitalization cost and the cost of other items. RESULTS The overall reduction in variance （RIV） for the DRG group of patients with malignant proliferative disease was 79.36%； the CV of other groups were all lower than one except that the RW21 group was 1.09. Compared with 2021， the hospitalization cost for patients with malignant proliferative disease in 2022 decreased by 17.80%， and the decreases in management fees and drug costs were 32.15% and 21.30%， respectively， while the per capita medical expenses increased by 17.26%. The new grey correlation degree of drug cost decreased， but that of medical expenses increased. CONCLUSIONS Under the DRG payment system， hospitalization costs for patients with malignant proliferative disease in the sample hospital decrease， but the grouping efficiency of RW21 and other disease groups needs improvement， and the cost structure needs optimization. |
| 期刊： | 2023年第34卷第13期 |
| 作者： | 向贵圆；伍渊麟；甘岚澜；陈世耕；刘耀 |
| AUTHORS： | XIANG Guiyuan，WU Yuanlin，GAN Lanlan，CHEN Shigeng，LIU Yao |
| 关键字： | 疾病诊断相关分组；恶性增生性疾患；分组效果；住院费用 |
| KEYWORDS： | diagnosis-related group； patients with malignant proliferative disease； grouping effect； hospitalization costs |
| 阅读数： | 147 次 |
| 本月下载数： | 4 次 |
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