基于病例组合指标的医生疾病治疗费用差异研究  

Analysis of Different Surgeons' Treatment Cost for Specific Diseases Based on Case Mix Index

作　　者：高源[1] 王青燕[1] 张文玲[1] 陈剑铭[1] 夏志伟[1] 吴虎兵[1] 

机构地区：[1]北京大学第三医院,北京100191

出　　处：《中国医院管理》2014年第2期34-36,共3页Chinese Hospital Management

摘　　要：目的应用诊断相关分组项目中的病例组合指标(CMI)分析医生对某一疾病患者的治疗方式及费用差异。方法选取某三级甲等医院胸外科肺恶性肿瘤疾病患者住院病例的住院首页信息(ICD-C34),提取不同患者疾病诊断的CMI值。采用非参数检验、Logistic分析病种的住院费用影响因素,包括医生、CMI等,比较参与治疗该病的4各医生之间差异。结果影响患者住院费用的主要因素是不同医生、CMI、住院日和患者年龄,不同医生诊治的患者的CMI无统计学差异,以住院费用为因变量、医生和CMI为自变量的Logistic分析结果表明CMI对住院费用具有影响。结论 CMI有可能作为一项重要指标用于评价医生对某一疾病治疗的合理性和工作质量。Objective To analyze the difference between surgeons＇ treatment methods and expenses based on the CMI of DRGs. Methods Calculating diagnoses CMI values based on the first sheet information of inpatient charts from patients with lung malignancy disease in cardiothoracic department of a 3A hospital, analyzing the factors affecting patients＇ treatment cost, including doctor and CMI, and comparing the difference between four surgeons treating the disease. Result The top 4 factors affecting the hospitalization expenses are surgeon, CMI, inpatient days and patients＇ age. There is no statistic difference of CMI among the surgeons. CMI has influence on hospitalization expense. Conclusion CMI can be used as an important index to evaluate the rationality and quality of surgeons＇ treatment to a certain disease.

关 键 词：医生 病例组合指标 特定疾病 治疗费用 

分 类 号：R197.323.2[医药卫生—卫生事业管理]