上海市三级医院疾病诊断分组系统的模拟与评估  

Stimulation and assessment of the diagnosis related grouping system in Shanghai tertiary hospitals

作　　者：胡敏[1] 祝菁菁[1] 朱碧帆 茅雯辉[1] 岑珏 孙木[3] 许岩 高解春 陈文[1] 

机构地区：[1]复旦大学公共卫生学院,上海200032 [2]上海申康医院发展中心,上海200041 [3]上海交通大学医学院附属瑞金医院,上海200025 [4]上海市红十字会,上海200040

出　　处：《中国卫生政策研究》2015年第9期19-24,共6页Chinese Journal of Health Policy

摘　　要：本研究利用上海市37家三级公立医院2013年12月的所有138 477条出院病例数据,根据本土化的病种分组器对其进行疾病分组,选用各组的变异系数(CV)指标对各组次均费用的离散度进行分析,以评价病种分组系统的适宜性,并设置各病种难度系数(相对权重)。研究发现基于危重度的疾病诊断分组系统适宜性较好,一致性也很高。在今后的研究中应收集更为详细的费用信息以体现医疗服务中的劳务和技术价值,并且进一步完善疾病分组,因地制宜地应用分组权重。This paper uses the data collected from 138,477 patient discharge records of 37 Shanghai tertiary public hospitals in December 2013 and classifies all the records into different groups by using a localized diagnosis re-lated group tool.The coefficient of variation index （ CV） of each group was used to analyze the dispersion of average hospital cost per inpatient day for each group, in order to evaluate the suitability of diagnosis related group systems and to set the coefficients of difficulty （ relative weights） for each disease.The study has found that severity-based di-agnosis related group systems are more suitable and consistent.However, future studies should collect more detailed information on health costs in order to reflect the value of health professionals and technologies and therefore further improve diagnosis related classification and develop new systems that can be adapted to local conditions by applying the weights of different groups.

关 键 词：疾病诊断分组 疾病危重度 适用性 变异系数 

分 类 号：R197[医药卫生—卫生事业管理]