基于DRG分析临床路径管理对住院费用的影响  

DRG-based analysis of the impacts on inpatient costs incurred clinical pathway management

作　　者：刘芳 尹龙燕[1] 关华[1] 吴惠贤 LIU Fang;YIN Longyan;GUAN Hua;WU Huixian(Guangzhou First People s Hospital,Guangzhou 510180,China)

机构地区：[1]广州市第一人民医院病案管理科

出　　处：《广州医药》2020年第1期74-77,共4页Guangzhou Medical Journal

摘　　要：目的运用DRG分析临床路径管理对患者住院费用的影响。方法采用BJ-DRGs分组器,选取2016年广州某三级综合医院的出院患者病案首页信息及DRG分组信息,对比是否实施临床路径管理对患者的总体住院费用影响及各DRG组的住院费用差异。结果路径组中位住院费用为9239.41元,低于对照组的12358.06元,差异有统计学意义(P<0.001)。费用构成分析发现,路径组的治疗费、检查费、药品费、手术费和其他费低于对照组,而材料费用相对较高。比较的14个DRG组中,6个DRG组的路径组住院费用低于对照组。结论实行临床路径管理可降低患者住院费用、改变费用构成。结合DRG积极推进临床路径精细化管理,可有效控制病种成本,遏制医疗费用的不合理增长。Objective Using DRG to analyze the impacts on inpatient costs of a hospital in Guangzhou as incurred by clinical pathway management.Methods As performed by BJ-DRGs,we selected DRG grouping information and medical record homepage information of the inpatients discharged from a tertiary hospital in Guangzhou in 2016.Then we compared the impacts of clinical pathway management on overall inpatients costs and the difference of inpatient costs for the DRG group.Results The median of inpatient costs in the clinical pathway group was 9239.41 yuan,was lower than that of control group which was 12358.06 yuan,and the difference was statistical difference(P<0.001).Cost composition analysis found that the costs of treatment,examination,medicine,surgery and the others in the clinical pathway group were much lower than that of the control group,while the cost of materials was relatively high.Among the 14 DRG group study,there were 6 DRG groups which the inpatient costs of the clinical path group was obviously lower than the control group.Conclusion The implementation of clinical pathway management may reduce the inpatient costs and change the makeup of costs.Therefore,combining with DRG,we actively promote the refined management of clinical pathway,which may effectively control the costs of diseases and the unreasonable growth of medical expenses.

关 键 词：DRG 临床路径 住院费用 

分 类 号：R197.32[医药卫生—卫生事业管理]