基于DRG不同微创方式治疗肝外胆道结石数据分析  

Data Analysis of Different Minimally Invasive Treatment Methods for Extrahepatic Bile Duct Stones Based on DRG

作　　者：刘宇[1] 杨伯钊[1] Liu Yu;Yang Bozhao(Department of Medical Records,Beijing Tongren Hospital Affiliated to Capital Medical University,Beijing 100730,China;不详)

机构地区：[1]首都医科大学附属北京同仁医院,北京市100730

出　　处：《中国病案》2021年第7期60-63,共4页Chinese Medical Record

摘　　要：目的探讨不同微创方式治疗肝外胆道结石对DRGs数据指标及分组结果的影响。方法统计并分析某院2018年1月1日-2019年12月31日间微创治疗肝外胆道结石相关病组内入选1683例的住院费用、住院时间、费用权重、手术操作等指标,比较同类型病组中有ERCP操作病例的分布及构成,并比较有ERCP操作病例与无ERCP操作病例的住院费用、住院时间及产能指标在相同病组内及不同病组间的差异。结果有ERCP操作病例在HD33组的比例(17.6%)显著高于HD35组(0.2%),并且在HJ1组的比例(75.2%)显著高于HL1组(24.1%)(P<0.001)。有ERCP操作病例在HD3组的住院时间及住院费用均显著高于HJ1、HL1组(P<0.001),其日均住院费用显著高于HD1+HD2组(P=0.007)及HD3组(P=0.010)内无ERCP操作病例,但其日均权重值却为最低(P<0.001)。共379例存在手术操作编码错误,操作编码质控后仅有27例分组结果发生改变,总权重值仅由550.11升高约5.78(1.05%)。结论病例分组结果受到操作编码及分组方案的影响,操作编码质控对提高病组总权重值的效果有限,而优化诊疗方案则为更佳选择。Objective To investigate the effect of different minimally invasive treatment methods for extrahepatic bile duct stones on DRG data indicators and grouping results.Methods The hospitalization expenses,length of stay,cost weight,operation and other indicators of the selected 1683 cases in the related groups of extrahepatic bile duct stones treated by minimally invasive treatment in our hospital from January 1st,2018 to December 31st,2019 were statistically analyzed,and the distribution and composition of cases with ERCP operation in the same group type were compared,and the hospitalization expenses,hospitalization time and productivity indexes of patients with ERCP operation and without ERCP operation were compared in the same group and between the different groups.Results The proportion of cases with ERCP operation in HD33 group(17.6%)was significantly higher than that in HD35 group(0.2%),and that in HJ1 group(75.2%)was significantly higher than that in HL1 group(24.1%),(P<0.001).The hospitalization time and hospitalization expenses of patients with ERCP operation in HD3 group were significantly higher than those in HJ1 and HL1 groups(P<0.001),and the average daily hospitalization expenses of these cases were significantly higher than that of cases without ERCP operation in HD1+HD2 groups(P=0.007)and HD3 group(P=0.010),but the daily average weight value of patients with ERCP operation in HD3 group was the lowest(P<0.001).A total of 379 cases had operation coding errors,only 27 cases of grouping results changed after operation code quality control,and the total weight value only increased by 5.78(1.05%)from 550.11.Conclusions The results of case grouping were affected by operation coding and grouping scheme,the effect of operation code quality control on improving the total weight value of group was limited,but optimizing the diagnosis and treatment scheme was a better choice.

关 键 词：疾病诊断相关分组 微创治疗 肝外胆道结石 联合手术 

分 类 号：R657.4[医药卫生—外科学]