口腔专科医院CHS-DRG模拟运行下特色手术病例费用分析  

Cost Analysis of CHS-DRG Simulated Cases of Specila Operation in a Dental Hospital

作　　者：吴易欣[1] 施祖东[1] 丁建芬[1] 宋颖[1] 王晓颖[1] WU Yi-xin;SHI Zu-dong;DING Jian-fen(Peking University and Hospital of Stomatology,Beijing,100081,China;不详)

机构地区：[1]北京大学口腔医院,北京100081

出　　处：《中国卫生经济》2022年第11期33-36,41,共5页Chinese Health Economics

摘　　要：目的:分析比较口腔专科医院DRG模拟运行中采用口腔颌面部游离/带蒂组织瓣移植修复术的入组病例的费用情况,为后续完善优化CHS-DRG分组方案提供参考依据。方法:选取北京市某三级甲等口腔专科医院2021年1月—2022年3月CHS-DRG模拟运行入组“DA1头颈恶性肿瘤大手术”“DG1腮腺及其他唾液腺手术”“DG2颅/面骨手术”的住院患者病案信息及DRG模拟运行数据。结果:3个组内行口腔颌面部游离/带蒂组织瓣移植修复术的费用明显高于未行口腔颌面部游离/带蒂组织瓣移植修复术的费用,差异有统计学意义(P<0.001);以是否行口腔颌面部游离/带蒂组织瓣移植修复术为依据再次分组后,各细分组CV均降低且趋近于0,提示可按此规则分组。结论:以口腔颌面部游离/带蒂组织瓣移植修复术的手术术式作为分组依据,不限制主要诊断,独立设立DRG组,提高权重系数,重新测算支付标准。Objective:To analyze the costs of the enrolled cases using free oral and maxillofacial/pedicled tissue flap transplantation and repair in the DRG simulation operation of a stomatology hospital,so as to provide a reference for the subsequent improvement and optimization of the CHS-DRG grouping scheme.Methods:Selected from January 2021 to March 2022 in the target tertiary first-class stomatology specialist hospital in Beijing,CHS-DRG simulation operation was included in the "DA1 head and neck malignant tumor major surgery", "DG1 parotid and other salivary gland surgery", "DG2 cranial/facial surgery", "Bone Surgery" inpatient medical record information and DRG simulation operation data.Results:In the three groups,the cost of "flap surgery group" was significantly higher than that of "no flap surgery group",and the difference was statistically significant(P<0.001);the coefficients of variation after subdivided groups based on whether comduct the oral and maxillofacial free/pedicled tissue flap transplan tation were decreased and tended to be 0,prompts can be grouped by this rule.Conclusion:Based on the surgical procedures of free or pedicled tissue flap transplantation and repair in the oral and maxillofacial region,the DRG group was established independently without limiting the main diagnosis,the weight coefficient was increased,and the payment standard was recalculated.

关 键 词：按疾病诊断相关分组 口腔专科医院 医疗费用 游离组织瓣移植修复术 带蒂组织瓣移植修复术 

分 类 号：R1-9[医药卫生—公共卫生与预防医学] R197