结核病患者DRG付费实施效果研究——以某三甲传染病专科医院为例  

Study on the Effect of DRG Payment on Tuberculosis Patients——Taking a Class Ⅲ Specialized Hospital of Infectious Disease as an Example

作　　者：黄连飘[1] 韦彩云[2] 黄丽群[2] 何华伟[2] 何春波 

机构地区：[1]南宁市第四人民医院结核科,南宁530023 [2]南宁市第四人民医院,南宁530023

出　　处：《中国医疗保险》2022年第4期75-77,共3页China Health Insurance

摘　　要：探讨广西定点结核病医疗机构对结核病住院患者实行DRG(疾病诊断相关分组)付费的效果,为医保DRG付费模式的精准推行提供参考依据。选取某三甲传染病专科医院2021年1月1日至2021年12月31日以结核病为主诊断(ADRG编码ES1)的患者3571例为研究对象,分为按项目付费(1741例)及DRG付费(1830例)两组。对两组患者的住院费用构成及费用结构及差异进行比较。得出推行DRG付费模式,可在充分保障医疗质量的前提下缩短平均住院日及合理控制医疗费用,但对药品及耗材的控费效果有限的结论。Objective:The paper explores the effect of DRG(Diagnosis-related Groups) on Guangxi designated medical institutions for inpatients with tuberculosis,so as to provide the reference for the precise implementation of DRG payment mode.Methods:A total of 3571 patients with tuberculosis diagnosed in a Class Ⅲ infectious disease hospital from January 1,2021 to December 31,2021(ADRG encoding ES1) were selected as the research objects.They were divided into two groups of fee-for-service payment(1741 cases) and DRG payment(1830 cases).The composition,structure and difference of hospitalization expenses between the two groups were compared.Conclusion:The implementation of DRG payment can shorten the average length of stay and reasonably control the medical expenses on the premise of fully ensuring the medical quality,but the effect of controlling the expenses of drugs and consumables is limited.

关 键 词：结核病 医疗保险 疾病诊断相关分组 住院费用 费用控制 

分 类 号：F840.684[经济管理—保险] C913.7[社会学]