肺恶性肿瘤DRG分组病例的费用结构及相关因素分析  

Analysis of Cost Structure and Related Factors of DRG Grouped Cases of Lung Malignant Tumor

作　　者：杨菁[1] 涂晓贤[1] Yang Jing;Tu Xiaoxian(Department of Medical Records,Affiliated Union Hospital of Fujian Medical University,Fuzhou 350000,Fujian Province,China;不详)

机构地区：[1]福建医科大学附属协和医院病案室,福建省福州市350000

出　　处：《中国病案》2022年第4期61-64,共4页Chinese Medical Record

摘　　要：目的 分析某三甲医院肺恶性肿瘤DRG分组住院费用结构、分组效果,探讨影响住院费用的相关因素,提出合理性建议,更好地控制好住院费用,合理地应用DRG。方法 选取某三甲医院2020年4月1日-2020年9月30日出院的肺恶性肿瘤DRG住院患者信息,应用描述性统计分析、方差分析、非参数检验和多元逐步回归等统计学方法,分析肺恶性肿瘤住院费用的结构,DRG分组的效果以及影响住院患者费用的因素,提出相关的合理性建议促进DRG应用和推广。结果 费用结构分析,其中治疗类占比最高(69.59%),检查类占比最低(16.68%);分组效果分析,组内变异系数均小于1,且各组间均有统计学意义(F=1.2233,P<0.001),综上所述说明DRG分组效果很好;影响住院费用的因素,参保类型、有无手术、是否为首次住院和患者年龄4个变量有统计学意义(P<0.05),回归模型的拟合度良好(P<0.001)。结论 肺恶性肿瘤DRG分组费用结构及DRG分组较合理,但个别分组费用还需优化,根据临床实际情况,优化医疗服务的流程,进一步提升医院管理水平,建立病种诊疗标准和规范,合理地应用DRG。Objective To analyze the structure and effect of the hospitalization expenses of the DRG group of lung malignant tumors in a hospital,to explore the relevant factors affecting the hospitalization expenses,to put forward reasonable suggestions,to better control the hospitalization expenses,to establish standards and norms for diagnosis and treatment of diseases,and to apply DRG reasonably.Methods To Selected the information of DRG inpatients discharged from a triple-A hospital from April 1,2020 to September 30,2020,apply statistical methods such as descriptive statistical analysis,variance analysis,non-parameter testing and multiple progressive regression,analyze the structure of hospitalization costs of lung malignant tumors,the effect of DRG grouping and factors affecting the cost of inpatients,and put forward relevant reasonable suggestions to promote the application and promotion of DRG.Results Cost structure analysis,of which the treatment category accounted for the highest proportion(69.59%),the examination category accounted for the lowest proportion(16.68%);Group effect analysis,the coefficient of variation in the group is less than 1,and each group has statistical significance(F=1.2233,P<0.001),the above shows that DRG grouping effect is very good;Factors affecting hospitalization costs,type of insurance,whether surgery is performed,whether it is a first-time hospitalization and whether the four variables of patient age are statistically significant(P<0.05),and the regression model is well fitted(P<0.001).Conclusion Lung malignant tumor DRG grouping cost structure and DRG grouping are more reasonable,but individual grouping need to be optimized,according to the actual clinical situation,optimize the process of medical services,further improve hospital management,establish standards and norms for diagnosis and treatment of diseases,reasonable application of DRG.

关 键 词：肺恶性肿瘤 DRG 费用结构 因素分析 

分 类 号：R197.323[医药卫生—卫生事业管理]