基于病组间相关性指标的护理项目定价合理性研究  

Study on the Rationality of Pricing of Nursing Items Based on the Correlation Index Between Disease Groups

作　　者：王奕又 陈隽[1] 张志媛[1] 邢宝心 赵冰洁 WANG Yiyou;CHEN Jun;ZHANG Zhiyuan;XING Baoxin;ZHAO Bingjie(Peking Union Medical College Hospital,Chinese Academy of Medical Sciences,Beijing 100730,China)

机构地区：[1]中国医学科学院北京协和医院,北京市100730 [2]中央财经大学会计学院,北京市100730

出　　处：《中国卫生信息管理杂志》2022年第4期594-603,共10页Chinese Journal of Health Informatics and Management

基　　金：国家卫生健康委卫生发展研究中心基金项目《通过业财融合优化医疗费用结构的研究》(项目编号:2019-10)。

摘　　要：目的 通过分析护理作业成本、作业强度与项目定价、病组付费标准间的相关性,以及不同付费方式对护理成本的补偿情况,为评价护理项目定价的合理性及护理工作的价值提供参考。方法 对医院4个DRG病组的225个出院病例,运用估时作业成本法计算护理作业成本,运用综合当量法计算护理作业强度、病组成本。结果 4个病组下78.53%的护理项目定价无法覆盖其作业成本,其中63.19%的项目定价无法覆盖其人力成本;病组成本、护理作业强度与病组付费标准、病例组合指数值一致。结论 护理项目定价与作业强度基本一致,但定价普遍过低;按病组付费的成本覆盖率优于按护理项目付费,医院应建立科学的护理评价机制以提高护理人员工作积极性。Objective to study the rationality of different payment methods for nursing labor compensation by analyzing the correlation between nursing activity cost,activity intensity,project pricing and disease group payment standards.Methods 225 sample cases covered 4 DRG groups were included in this study,the nursing operation cost was calculated by using the estimated time operation cost method,the nursing operation intensity was calculated according to the weight of key nursing operation items,and the disease group cost was calculated by using the comprehensive equivalent method.Result 78.53%of the nursing project pricing could not cover its activity costs,of which 63.19%of the labor costs could not be covered;The total cost and nursing operation intensity of the disease group were consistent with the payment weight and CMI value of the disease group.Conclusion the relationship between nursing item pricing and operation intensity is basically reasonable,but the pricing is generally too low.The overall cost coverage of paying by disease group is better than paying by nursing items. It is necessary for the hospital to establish a scientific nursing evaluation mechanism to further improve the work enthusiasm of nurses.

关 键 词：护理作业成本 作业强度 项目定价 病组成本 

分 类 号：R-34[医药卫生] R319