DRG付费下恶性肿瘤住院费用管理策略及评价视角  

Study on the Management Strategy and Evaluation of Hospitalization Expenses for Malignant Tumors on DRG Payment

作　　者：马雷[1,2] 柳俊杰 龚海英[3] 龚超 朱晓伟 

机构地区：[1]天津医科大学肿瘤医院,天津300060 [2]天津市肿瘤医院空港医院医疗保险部,天津300308 [3]北京市房山区卫生健康委员会,北京102401 [4]天津市卫生健康发展研究中心,天津300052 [5]天津市第三中心医院,天津300170

出　　处：《中国医疗保险》2022年第12期73-77,共5页China Health Insurance

基　　金：天津医科大学2020年度医院管理创新项目(2020YG11);天津市卫生健康委员会科技项目(TJWJ2021QN025)。

摘　　要：目的:分析恶性肿瘤住院患者费用构成差异及个人负担情况,为医疗机构深入推进DRG付费和加强精细化管理提供建议。方法:利用SPSS19.0软件对费用构成差异性、患者个人负担等数据进行方差分析。结果:不同医师的费用构成存在差异,药品费和卫生材料费差异显著,组间差异有统计学意义(P<0.05)。患者个人负担构成中,医保支付范围以外的费用所占比例较大。结论:定点医疗机构应加强对DRG病组管理,控制医疗费用不合理增长。Objective:The paper analyzes the difference of cost composition and individual burden of inpatients with malignant tumor to provide suggestions for promoting DRG payment and strengthening fine management in medical institutions.Methods:SPSS19.0 software was used to analyze the variance of cost composition and patient's economic burden.Results:There were differences in the expenses composition among physicians,and there were significant differences in the cost of medicines and sanitary materials,with statistical significance among groups(P<0.05).Among patients'economic burden,the expenses beyond the scope of medical insurance accounted for a large proportion.Conclusion:Designated medical institutions should strengthen the management of DRG group and control the unreasonable increase of medical expenses.

关 键 词：DRG 医保 费用管理 

分 类 号：F840.684[经济管理—保险] C913.7[社会学]