基于疾病诊断相关分组的慢性阻塞性肺病患者住院费用影响因素分析  

Analysis of influencing factors of hospitalization expenses for patients with chronic obstructive pulmonary disease based on diagnosis related groups

作　　者：黎永锋[1] 余楚红[2] Li Yongfeng;Yu Chuhong(Department of Medical Records, Jiangmen Central Hospital, Jiangmen 529030, China;Medical Insurance Department, Jiangmen Central Hospital, Jiangmen 529030, China)

机构地区：[1]江门市中心医院病案科,广东江门529030 [2]江门市中心医院医保科,广东江门529030

出　　处：《中国医院统计》2021年第4期339-342,共4页Chinese Journal of Hospital Statistics

摘　　要：目的探讨疾病诊断相关分组(DRGs)的慢性阻塞性肺病(COPD)患者的住院费用影响因素。方法分析2019年江门市某三级公立医院989例COPD住院患者DRGs分组评价情况,应用变异系数CV进行组内比较,应用秩和检验进行组间比较,应用多元线性回归进行影响住院费用的多因素分析。结果COPD患者主要分布在慢性气道阻塞病、伴重要合并症与伴随病(ET11),慢性气道阻塞病、伴合并症与伴随病(ET13)与慢性气道阻塞病、不伴合并症与伴随病(ET15)3个DRGs组,ET11分组情况较差,ET13与ET15分组情况较好。ET11组的时间指数高于1,ET13与ET15组的时间消耗指数低于1,3组的费用消耗指数均高于1,3组之间住院费用的差异有统计学意义。ET11组住院费用的影响因素为住院天数、是否抢救、年龄和全自费;ET13组住院费用的影响因素为住院天数和新农合医保;ET15组住院费用的影响因素为住院天数。结论DRGs可作为控制COPD患者住院费用的管理工具,降低COPD患者的住院费用,从而减轻患者的疾病负担。Objective To explore the factors influencing the hospitalization expenses of patients with chronic obstructive pulmonary disease(COPD)in groups related to disease diagnosis.Methods The DRG evaluation of 989 COPD inpatients in a tertiary public hospital in Jiangmen City in 2019 was analyzed.The coefficient of variation CV was used for intra-group comparison,the rank sum test was used for inter-group comparison,and multiple linear regression was used for multivariate analysis of factors influencing hospital expenses.Results COPD patients were mainly distributed in three DRGs,including chronic airway obstructive disease with important comorbidities and concomitant diseases(ET11),chronic airway obstructive disease with comorbidities and concomitant diseases(ET13),and chronic airway obstructive disease without comorbidities and concomitants Disease(ET15).The grouping of ET11 was poor,and the grouping of ET13 and ET15 was better.The time index of the ET11 group was higher than 1,the time consumption index of the ET13 and ET15 groups was lower than 1,and the expense index of the 3 groups were all higher than 1.The difference in hospitalization expenses among the 3 groups was statistically significant.The influencing factors were the length of stay in hospital,rescue,age,and full self-finance for the group ET11;the influencing factors of hospitalization expenses in the ET13 group were the length of hospitalization and the new rural cooperative medical insurance;the influencing factors of hospitalization expenses in the ET15 group were the length of hospitalization.Conclusion DRGs can be used as a management tool to control the hospitalization expenses of COPD patients,and to reduce the hospitalization expenses of COPD patients,thereby to reduce patients′disease burden.

关 键 词：疾病诊断相关分组 慢性阻塞性肺病 住院费用 

分 类 号：R197.32[医药卫生—卫生事业管理]