DRG支付方式改革对医生医疗行为的影响研究  

Study on the impact of DRG payment mode reform on medical behavior of doctors

作　　者：马燕[1] MA Yan(Maternal and Child Health Hospital of Bao′an District,Guangdong Province,Shenzhen518101,China)

机构地区：[1]深圳市宝安区妇幼保健院,广东深圳518101

出　　处：《中国当代医药》2021年第21期205-208,213,共5页China Modern Medicine

摘　　要：目的探讨按疾病诊断相关分组(DRG)支付方式的改革对医生医疗行为的影响。方法本研究运用网络问卷调查的方式,选取2020年6月—2021年5月深圳市宝安区妇幼保健院的84份有效问卷,从医生对DRG支付方式的认知、DRG支付方式改革对医生行为的影响和DRG支付对卫生服务质量的影响3个维度进行分析研究。结果有88.1%的医生表示大概知道或非常了解DRG支付方式改革,61.9%的医生表示支持DRG支付方式改革。大部分医生认为DRG支付最突出的优点是规范诊疗行为(70.2%)和促进分级诊疗(69.0%),而最大的不足之处是医生自主性受到过多限制(72.6%)。48.8%的医生认为DRG支付对医疗行为有较大的影响;83.3%的医生认为实行DRG支付方式后不影响收治患者情况;84.5%的医生认为实行DRG支付方式后对医疗费用的关注增加;90.5%的医生认为实行DRG支付方式不影响门诊量。70.2%、83.3%和63.1%的医生认为患者再入院率、并发症发生率和次均住院费用在DRG支付方式改革后均未受影响。结论通过研究DRG付费制度对医疗行为的影响关系,可以进一步规范医务人员的医疗行为,医院开展DRG试点提供决策支持,促进DRG付费方式改革的进一步完善。Objective To explore the impact of diagnosis related group(DRG)payment reform on medical behavior of doctors.Methods In this study,84 valid questionnaires were selected from the Maternal and Child Health Hospital of Bao′an District,Shenzhen from June 2020 to May 2021,and analyzed and studied from three dimensions:the cognition of doctors of DRG payment mode,the impact of DRG payment reform on doctors′behavior and the impact of DRG payment on the quality of health services.Results The results showed that 88.1%of doctors said they were generally aware of or very familiar with the reform of DRG payment methods,and 61.9%of doctors said they supported the reform of DRG payment methods.The majority of doctors believed that the most prominent advantage of DRG payment was to regulate the behavior of diagnosis and treatment(70.2%)and to promote graded diagnosis and treatment(69.0%),while the biggest disadvantage was that the autonomy of doctors was too limited(72.6%).The results showed that 48.8%of doctors believed that DRG payments had a significant impact on medical behavior;83.3%of the doctors thought that the implementation of DRG payment method would not affect the conditions of patients admitted;84.5%of doctors believed that there was an increase in concern about medical costs after the implementation of DRG payment;90.5%of doctors believed that the implementation of DRG payment would not affect the number of outpatient visits.70.2%,83.3%and 63.1%of the doctors thought that the rate of patient readmission rate,the incidence of complications and the average hospitalization cost per time were not affected by the reform of DRG payment method,respectively.The results showed that 70.2%,83.3%and 63.1%doctors thought that the rate of patient readmission,complication rate and average hospitalization cost per time were not affected by the reform of DRG payment method.Conclusion By studying the relationship between DRG payment system and medical behavior,the medical behaviors of medical staff can be further standardized,i

关 键 词：按疾病诊断相关分组 支付改革 医疗行为 医生 

分 类 号：R197.3[医药卫生—卫生事业管理]