经皮冠状动脉支架置入术医保DRGs实际付费探究  

Study on the Actual Payment of Medical Insurance DRGs for Percutaneous Coronary Stent Implantation

作　　者：赵红[1] 张琴[1] Zhao Hong;Zhang Qin(West Branch of Beijing Chaoyang Hospital Affiliated to Capital Medical University,Beijing 100043,China;不详)

机构地区：[1]首都医科大学附属北京朝阳医院西院区,北京市100043

出　　处：《中国病案》2023年第4期44-46,共3页Chinese Medical Record

摘　　要：目的通过分析经皮冠状动脉支架置入术组实施医保DRGs实际付费前后相关医疗费用指标,探讨DRGs付费方式对临床费用的多方面影响。方法选取某三甲医院2020年1月1日-2020年7月31日期间未实施医保DRGs付费的冠状动脉支架置入术组病例84份作为对照组;选取2021年1月1日-2021年7月31日实施DRGs医保实际支付的冠状动脉支架置入术组病例78份作为观察组,比较两组病例的患者一般情况、例均费用、平均个人支付费用、平均耗材费用、平均检查费用、平均手术费用及平均化验费用等信息,采用SPSS16.0统计软件对所得数据进行统计学处理。结果冠状动脉支架置入术组病例实施DRGs医保支付方式后,平均住院天数由对照组9.34天下降为观察组的8.5天,例均费用由对照组57332.04元下降为观察组33576.30元,平均耗材费用由对照组41253.33元下降为观察组16608.46元,两组间比较,P<0.05,差异具有统计学意义。个人支付费用、平均检查费用、平均手术费用、平均化验费用两组间比较,均P<0.05,差异具有统计学意义。两组平均药费比较,差异无统计学意义,P>0.05。结论DRGs医保付费的应用有利于控制医疗费用,降低耗占比,减轻患者及社会负担,体现医疗技术人员劳动价值。Objective To analyze the indexes of medical expenses before and after DRGs payment for medical insurance"percutaneous coronary stenting"diseases(FM19 group),and explore the various effects of DRGs payment methods on clinical expenses.Methods 84 FM19 cases without DRGs medical insurance payment in a Three A and Tertiary Hospital from January to July 2020 were selected as the control group,and 78 FM19 cases with DRGs medical insurance payment in the same period from January to July 2021 were selected as the observation group.The expenses of the two groups were compared and analyzed by spss160 statistical software processes the data.Results After the implementation of DRGs medical insurance payment method in FM19 group,the average hospital stay decreased from 9.34 days in the control group to 8.5 days in the observation group,the average case cost decreased from 57332.04 yuan in the control group to 33576.30 yuan in the observation group,and the average consumables cost decreased from 41253.33 yuan in the control group to 16608.46 yuan in the observation group.The difference between the two groups was statistically significant(P<0.05).At the same time,the individual payment cost,average examination cost,average operation cost,average laboratory cost,etc.were compared between the two groups(P<0.05),and the difference was statistically significant.There was no significant difference in the average drug cost between the two groups(P>0.05).Conclusions The application of DRG medical insurance payment was conducive to controlling medical expenses,reducing the proportion of consumption,reducing the burden on patients and society,and reflecting the labor value of medical technicians.

关 键 词：DRGs医保支付 经皮冠状动脉支架置入术 费用控制 

分 类 号：R197.32[医药卫生—卫生事业管理]