专科医院医疗新技术应用推广对DRG付费的影响研究  

Study on the Impact of New Medical Technology Application and Popularization on DRG Payment in Specialized Hospitals

作　　者：赵昂 陈善豪[1] 张哲民[1] ZHAO Ang;CHEN Shan-hao;ZHANG Zhe-min(Medical Department,Shanghai Pulmonary Hospital,Shanghai 200433,China)

机构地区：[1]上海市肺科医院医务处,上海200433

出　　处：《中国卫生经济》2023年第5期77-79,共3页Chinese Health Economics

基　　金：2021年度上海市医院协会医院医疗保险管理专业委员会课题。

摘　　要：目的:分析专科医院医疗新技术应用推广对DRG付费的影响,为制定合理的DRG付费政策提供科学依据。方法:选取2021年上海市医保支付方式改革信息服务平台的医院病案数据,运用独立样本t检验、卡方检验和秩和检验分析医疗新技术的使用对医院胸部大手术(EB19)的医疗费用、住院天数和医疗质量的影响。结果:应用医疗新技术增加了患者的住院天数和医疗费用,且对医疗费用中的各分项费用产生影响,甚至会造成医院的亏损;但在医疗质量上,使用医疗新技术的患者医疗质量指标的表现均优于未使用的患者。结论:DRG付费下,为推进医疗新技术的开展,推动医院高质量发展,需制定合理的医疗新技术支付政策,避免医院亏损。同时,医院需加强医疗新技术监管,保障医疗质量和安全。Objective:To analyze the impact of the application and promotion of new technology on the payment of surgical patients'Diagnosis Related Group(DRG)in a special hospital so as to provide scientific basis for the formulation of reasonable DRG payment policy.Methods:The hospital medical record data of Shanghai medical insurance payment reform information service platform in 2021 were selected and included into the new technology(diagnosis and treatment items)carried out in the past two years and filed by the superior department.Independent sample T-test,Chi-square test and rank sum test were used to analyze the influence of the use of new technology on the cost,length of stay and quality index of major breast surgery(EB19)in hospitals.Results:The application of new technology increased the number of days in hospital and medical expenses of patients,and had an impact on the itemized costs of medical expenses,even causing losses to the hospital.However,in terms of medical quality,the performance of patients who used new medical technology was better than those who do not use it.Conclusion:Under the DRG payment,in order to promote the development of new technology and promote the high-quality development of hospitals,it is necessary to formulate a reasonable payment policy for new technology to avoid the cost loss of medical institutions.Meanwhile,medical institutions need to strengthen medical technical supervision to ensure medical quality and safety.

关 键 词：专科医院 医疗新技术 按疾病诊断相关分组 支付方式改革 

分 类 号：R1-9[医药卫生—公共卫生与预防医学] F224.5[经济管理—国民经济]