基于临床路径制定住院费用标准的研究  

Study of designing the standard interval for hospitalization costs based on clinical pathway

作　　者：阿布都沙拉木·依米提[1] 朱琳[1] 陈浦兰[1] 再依奴尔·阿不都外力[1] 赵婷[1] 阿里木江·艾山[2] 

机构地区：[1]新疆医科大学附属肿瘤医院,乌鲁木齐830011 [2]新疆医科大学公共卫生学院

出　　处：《中华医院管理杂志》2012年第4期274-276,共3页Chinese Journal of Hospital Administration

基　　金：新疆医科大学科研创新基金项目（XJC201027）

摘　　要：目的以临床路径病例为基础，制定住院费用标准，为合理控制病种住院费用提供参考依据。方法通过多因素回归分析筛选出子宫肌瘤住院费用的影响因素，采用疾病诊断相关组（DRGs）病例组合方法，对1777例子宫肌瘤患者进行分组。结果影响子宫肌瘤患者住院费用的主要因素按其作用强度，依次为是否手术治疗、伴随疾病及其数量，调整R^2=0．6545。子宫肌瘤病例共分为4个组合，变异系数（CV）均较小，分别为0．068、0．104、0．102、0．116，并测算了4个病例组合住院费用的标准值。结论通过疾病诊断相关组（DRGs）病例组合方法制定的住院费用标准区间是合理有效的，对规范诊疗活动和控制高额住院费用具有积极意义。Objective To set the cost standards for hospitalization based on the cases of the clinical pathway in order to help set a reasonable ceiling for the expenses of various diseases. Methods The multiple linear regression analysis was applied to find out influencing factors of hospitalization costs of the hysteromyoma. Diagnosis Related Groups（DRGs）case mix was used to group 1777 hysteromyoma cases. Results The main factors for the expenses,as listed by their influence,were surgical operation or not, disease（s） of concomitance and the amount, adjusted R^2 = 0. 6545. Hysteromyoma patients were divided into four diagnosis related groups; the all coefficient of variation（CV）is as small as 0. 068, 0. 104, 0. 102, and 0. 116 respectively. The hospitalization costs of the hysteromyoma of standard reference value were then calculated. Conclusion The standards interval for hospitalization costs set with DRGs case mix is reasonable and efficient, significantly useful for regulating medical practice and harnessing excessive costs of hospitalization.

关 键 词：病例组合 诊断相关组 住院费用 临床路径 

分 类 号：R197.3[医药卫生—卫生事业管理]