疾病诊断相关分组点数付费对产妇分娩住院费用的影响  

Impact of diagnosis-related groups point payment on hospitalization costs of parturition among lying-in women

作　　者：傅君[1] 丁苗苗 朱亚飞[1] FU Jun;DING Miaomiao;ZHU Yafei(Department of Medical Records and Statistics,Ningbo Women and Children's Hospital,Ningbo,Zhejiang 315000,China)

机构地区：[1]宁波市妇女儿童医院病案统计科,浙江宁波315000

出　　处：《预防医学》2023年第1期78-82,共5页CHINA PREVENTIVE MEDICINE JOURNAL

基　　金：浙江省医药卫生科技计划项目(2020KY880)。

摘　　要：目的 分析疾病诊断相关分组(DRGs)点数付费对产妇分娩住院费用的影响,为减轻产妇负担、节约医疗资源提供参考。方法 通过宁波市某三甲妇女儿童医院住院病案系统和DRG运营分析系统收集2020—2021年分娩产妇的年龄、孕周、产次、住院时间、DRG分组和住院费用等资料,比较DRGs点数付费实施前后产妇分娩住院费用变化,并采用多因素logistic回归模型分析DRGs点数付费与产妇分娩住院总费用的关系。结果 DRGs点数付费实施前后分别纳入10 871和11 505名产妇,年龄≤30岁分别为6 208和6 216人,占57.11%和54.03%。DRGs点数付费实施后产妇分娩住院总费用、材料费和化验费的M (QR)分别为8 519.19 (2 456.61)、881.38 (816.16)和939.00 (310.00)元,均低于实施前产妇的9 123.13 (2 660.33)、915.57 (825.26)和1 036.00 (385.00)元(Z=-21.971、-16.061、-27.199,均P<0.001)。多因素logistic回归分析结果显示,调整年龄、住院时间、孕周、产次、分娩方式和并发症后,DRGs点数付费与更低的产妇分娩住院总费用存在统计学关联(OR=0.462,95%CI:0.432~0.494)。结论 DRGs点数付费有利于降低产妇分娩住院费用。Objective To examine the effect of diagnosis-related groups (DRGs) point payment on hospitalization costs of parturition among lying-in women,so as to provide the evidence for alleviating the burdens and saving medical resources among lying-in women.MethodsLying-in women’s age,gestational age,parity,duration of hospital stay,DRGs grouping and hospitalization costs were collected from the Inpatient Medical Record System and DRG Operation Analysis System in a tertiary women and children’s hospital in Ningbo City from 2020 to 2021.The changes of hospitalization costs of parturition were compared among lying-in women before and after DRGs point payments,and the association between DRGs point payments and gross hospitalization costs of parturition was examined among lying-in women using a multivariable logistic regression analysis.ResultsA total of 11 505 lying-in women after DRGs point payments,including 6 216 women at age of 30 years and below (54.03%),and 10 871 lying-in women before DRGs point payments,including 6 208 women at age of 30 years and below (57.11%),were enrolled.The median (interquartile range) gross hospitalization expenses,material expenses and laboratory testing expenses of parturition were 8 519.19(2 456.61),881.38 (816.16) and 939.00 (310.00) Yuan among lying-in women after DRGs point payments,which were significantly lower than those[9 123.13 (2 660.33),915.57 (825.26),1 036.00 (385.00) Yuan]among lying-in women before DRGs point payments (Z=-21.971,-16.061 and-27.199,all P<0.001).Multivariable logistic regression analysis showed that DRGs point payment was statistically associated with lower gross hospitalization expenses of parturition among lying-in women after adjustment for age,duration of hospital stay,gestational age,parity,type of delivery and development of complications (OR=0.462,95%CI:0.432-0.494).ConclusionDRGs point payment is beneficial to reduce the hospitalization cost of parturition among lying-in women.

关 键 词：疾病诊断相关分组 点数付费 住院费用 分娩 

分 类 号：R17[医药卫生—妇幼卫生保健]