DRG-PPS在云南省三级医院医疗费用控制中的应用  

The Application of DRG-PPS on the Medical Cost Control of Tertiary Hospitals in Yunnan

作　　者：徐本记 徐倩 冯瑞芳 耿建利 高华斌[4] 陆烨 XU Ben-ji;XU Qian;FENG Rui-fang(No.920 Hospital of PLA,Kunming,650032,China)

机构地区：[1]中国人民解放军联勤保障部队第九二〇医院,昆明650032 [2]昆明市第二人民医院,昆明650204 [3]昆明同仁医院,昆明650228 [4]昆明医科大学第一附属医院医院质量管理部,昆明650032 [5]昆明医科大学人文与管理学院,昆明650500

出　　处：《中国卫生经济》2020年第3期83-85,共3页Chinese Health Economics

基　　金：云南省教育厅科学研究基金项目(2018JS174);云南省医疗保险基金管理中心课题(2017HP013);昆明医科大学“十三五”校级学科建设项目(J1301823);昆明医科大学2018年校级特色扶持专业建设项目“劳动与社会保障”(J13414006)。

摘　　要：目的:研究DRG-PPS支付方式在云南省三级医院内部医疗费用控制的应用。方法:通过对云南省三级医院2017—2018年的内部医疗费用变化趋势,评价DRG-PPS在内部医疗费用控制管理中的应用效果。结果:经过统计与分析,云南省30家三级医院在2017年的年度DRG总量为1 850 135例,2018年的年度DRG总量为2 017 778例,相较于2017年有了明显的增长(P<0.05)。在时间消耗评价方面,2017年住院患者平均住院时间为9.721±8.39天,在2018年为9.584±7.88天。时间消耗指数在2017年为1.037±0.673,在2018年为1.032±0.628。总的时间消耗减少,时间消耗指数更接近1 (P<0.05)。在费用消耗评价方面,住院患者平均费用消耗在2017年为1.080±0.532万元,在2018年为1.065±0.511万元。费用消耗指数在2017年为0.969±0.361,在2018年为0.973±0.420。总的费用消耗下降,且费用消耗指数更接近1 (P<0.05)。在安全性评估方面,2017年30家三级医院的年度平均低风险死亡率为0.007 67±0.001 2%,2018年的年度平均低风险死亡率为0.005 33±0.00 09%,2018年的年度平均低风险死亡率低于2017年,且P<0.05。结论:DRG-PPS在云南省三级医院内部医疗费用控制的应用效果逐年上升,在后续的实践中,应当继续深入推进并持续评价观测。Objective:To study the application of DRG-PPS payment method in the internal medical cost control of gradeⅢhos pitals in Yunnan.Methods:The application effect of DRG-PPS in internal medical cost control and management was evaluated through the change trend of internal medical cost in the tertairy hospitals in Yunnan from 2017 to 2018.Results:Through the statis tics and analysis,the annual total number of DRG in 30 tertiary hospitals in Yunnan in 2017 was 1850135,and the annual total number of DRG in 2018 was 2017778,which showed an obvious increase compared with that in 2017(P<0.05).In terms of time consumption evaluation,the average length of hospitalization was 9.721±8.39days in 2017 and 9.584±7.88days in 2018.The time con sumption index was 1.037±0.673 in 2017 and 1.032±0.628 in 2018.The total time consumption decreased and the time consumption index was closer to 1(P<0.05).In terms of cost evaluation,the average cost of inpatients was 10.80±5.32 thousand yuan in 2017 and 10.65±5.11 thousand yuan in 2018.The cost consumption index was 0.969±0.361 in 2017 and 0.973±0.420 in 2018.Total cost con sumption decreased,and the cost consumption index was closer to 1(P<0.05).In terms of safety assessment,the annual average lowrisk mortality rate of 30 tertiary hospitals in 2017 was 0.00767±0.0012%,the annual average low-risk mortality rate in 2018 was 0.00533±0.0009%,and the annual average low-risk mortality rate in 2018 was lower than that in 2017,and P<0.05.Conclusion:The application effect of DRG-PPS in the medical cost control of tertiary hospitals in Yunnan is increasing year by year.In the fol low-up practice,it should be further promoted and continuously evaluated and observed.

关 键 词：按疾病诊断相关分组与预付费制度 三级医院 医疗费用控制 云南 

分 类 号：R1-9[医药卫生—公共卫生与预防医学] R197.323