DRGs对医院外科肿瘤化疗病种的影响分析  

Analysis of DRG Impact on Disease Types of Surgical Tumor Chemotherapy in Hospitals

作　　者：蒋文博 席洁君 梁浩晖[1] 刘莉[1] JIANG Wen-bo;XI Jie-jun;LIANG Hao-hui;LIU Li(Shenzhen Second People’s Hospital,Shenzhen 518000,China;Institute for Hospital Management of Tsinghua University,Shenzhen 518000,China)

机构地区：[1]深圳市第二人民医院,广东省深圳市518000 [2]清华大学医院管理研究院,广东省深圳市518000

出　　处：《现代医院管理》2023年第4期59-62,共4页Modern Hospital Management

基　　金：广东省卫生经济学会基金项目(2021-WJMF-19)。

摘　　要：目的分析DRGs实施对外科病种结构的影响,以肿瘤化疗为例,为医院内部分级诊疗和病种优化提出建议。方法提取广东省病案统计系统中某三级医院2018—2021年胃肠外科、胸外科出院患者信息,采用倾向性评分匹配分析(PSM)DRGs实施前后恶性肿瘤化疗病人住院情况变化。结果经匹配后,胃肠外科恶性肿瘤、胸外科恶性肿瘤化疗患者占总出院患者的比例由DRGs实施前的30.9%、33.7%降为实施后的18.8%、17.5%,占比减少,差异具有统计学意义(P<0.05)。结论DRGs实施后外科肿瘤化疗患者占比减少,病种结构得到优化,DRGs促使医院优化诊疗方案、合理配置医院医疗资源,促进医院精细化管理。Objective:To analyze the impact of DRGs implementation on the disease structure of surgical departments,and propose the suggestions for internal grading diagnosis and treatment,and disease optimization in hospitals by taking tumor chemotherapy as an example.Method:The information of discharged patients from gastrointestinal surgery and thoracic surgery in a third-grade hospital from 2018 to 2021 was extracted from Guangdong Province’s medical record statistics system,and the changes of hospitalized patients with malignant tumor chemotherapy before and after the implementation of DRGs were analyzed by propensity score matching(PSM).Result:After the matching,the proportion of patients receiving chemotherapy for malignant tumors in gastrointestinal surgery and thoracic surgery in total discharged patients decreased from 30.9%and 33.7%before DRGs implementation to 18.8%and 17.5%after DRGS implementation,with statistical significance(P<0.05).Conclusion:After the implementation of DRGs,the proportion of surgical tumor chemotherapy patients has decreased,and the disease structure has been optimized.DRGs encourages hospitals to optimize diagnosis and treatment plans,allocate medical resources reasonably,and promote refined hospital management.

关 键 词：疾病诊断相关分组 肿瘤化疗 病种结构 倾向性评分匹配 

分 类 号：R197[医药卫生—卫生事业管理]