基于DRG的北京市属医院小儿肺炎住院费用结构分析  

Analysis on the Structure of Hospitalization Expenses for Pediatric Pneumonia in Beijing Municipal Hospitals based on DRG

作　　者：崔媛媛 陈晖[1] Cui Yuanyuan;Chen Hui(Beijing Children's Hospital,Capital Medical University,National Certer for Children’s Health;不详)

机构地区：[1]国家儿童医学中心首都医科大学附属北京儿童医院,100045

出　　处：《中国病案》2023年第7期95-98,共4页Chinese Medical Record

基　　金：北京市医院管理中心儿科学科协同发展中心“儿科专项”(XTCX201801)。

摘　　要：目的分析北京市属医院小儿肺炎住院费用结构,为合理控制医疗费用提出建议,为实现医院间医疗同质化发展提供参考。方法选取2017年-2019年北京市属医院小儿肺炎DRG分组编码ES10同组病例为研究对象,采用结构变动度分析法和新灰色关联分析法深入分析小儿肺炎住院费用结构情况。结果综合医疗服务类一直呈正向变动,中医类、中药类、耗材类、血液和血液制品类一直呈负向变动,2017年-2019年结构变动度为13.45%,结构变动贡献率前四位依次为诊断类(29.43%)、中药类(26.68%)、综合医疗服务类(20.40%)和耗材类(10.33%),费用项目关联前三位依次为诊断类(0.95)、综合医疗服务类(0.84)和西药类(0.81)。结论诊断类是影响住院例均费用及其结构变动的首要因素,其次是综合医疗服务类;中药类和耗材类是影响住院费用结构变动的主要因素,但对例均费用影响较弱;西药类是导致住院例均费用增长的主要项目。Objectives This study aims to analyze the hospitalization cost structure of pediatric pneumonia in Beijing municipal hospitals,so as to provide suggestions for reasonable control of medical costs and provide reference for the development direction of medical homogenization among hospitals.Methods The same group of pediatric pneumonia cases with DRG grouping code ES10 in Beijing Municipal hospitals from 2017 to 2019 were selected as the research objects.The structural change degree analysis method and the new gray relational analysis method were used to deeply analyze the structure of hospitalization expenses for children with pneumonia.Results Comprehensive medical services had been changing in a positive direction,while traditional Chinese medicine,traditional Chinese medicine,consumables,blood and blood products had been changing in a negative direction.The structural change from 2017 to 2019 was 13.45%.The top four of structural change contribution rate were diagnosis(29.43%),traditional Chinese medicine(26.68%),comprehensive medical service(20.40%)and consumables(10.33%).The top three items related to expenses were diagnosis(0.95),comprehensive medical services(0.84)and western medicine(0.81).Conclusions Diagnosis was the most important factor affecting the cost of hospitalization and its structure,followed by comprehensive medical service.Traditional Chinese medicine and consumables were the main factors affecting the change of hospitalization cost structure,but the effect on the average cost per case was weak.Western medicine was the main item leading to the increase of the average cost of inpatients.

关 键 词：小儿肺炎 住院费用结构 结构变动 费用项目 DRG 

分 类 号：R197.32[医药卫生—卫生事业管理]