DRG背景下不稳定型心绞痛住院患者医疗费用分析  

Analysis of medical expenses of inpatients with unstable angina in the background of DRG

作　　者：李雪 高浑敏 平卫伟 李韶霞[3] 降凌燕[3] LI Xue;GAO Hunmin;PING Weiwei;LI Shaoxia;JIANG Lingyan(School of Public Health,Shanxi Medical University,Taiyuan Shanxi 030000,China;Department of Public Health and Preventive Medicine,Changzhi Medical College,Changzhi Shanxi 046000,China;Department of Medical Record Management,Heping Hospital Affiliated to Changzhi Medical College,Changzhi Shanxi 046000,China)

机构地区：[1]山西医科大学公共卫生学院,山西太原030000 [2]长治医学院公共卫生与预防医学系,山西长治046000 [3]长治医学院附属和平医院病案管理科,山西长治046000

出　　处：《卫生软科学》2023年第11期67-70,共4页Soft Science of Health

基　　金：山西省教育科学“十四五”规划课题(GH-21565)。

摘　　要：[目的]分析DRG实施前后不稳定型心绞痛住院患者的医疗费用变化情况。[方法]收集2020年1月-2022年10月山西省某三甲医院不稳定型心绞痛患者病案首页的相关信息,采用倾向性评分匹配法分别对非DRG组和DRG-1组、DRG-1组和DRG-2组进行匹配,分别比较两组患者医疗费用的变化情况。[结果]DRG-1组的住院天数、住院总费用低于非DRG组,DRG-2组的住院天数、住院总费用低于DRG-1组,差异均有统计学意义(P<0.05)。在住院费用项目构成中,DRG-1组与非DRG组相比,医用材料费和护理费占比下降,治疗费、药费、诊断费、医疗服务费、操作费和其他费用占比增长;DRG-2组与DRG-1组相比,医用材料费、治疗费、药费占比降低,诊断费、医疗服务费、操作费、护理费和其他费用占比增长。[结论]DRG对不稳定型心绞痛住院患者控费效果显著,DRG持续实施有助于有效控制医疗费用,并优化费用结构。Objective To analyze the changes of medical expenses of inpatients with unstable angina before and after the implementation of DRG.Methods Relevant information on the first page of medical records of patients with unstable angina in a grade-A tertiary hospital in Shanxi Province from January 2020 to October 2022 was collected.The non-DRG group and DRG-1 group,DRG-1 group and DRG-2 group were matched by the propensity score matching method,and the changes of medical expenses in the two groups were compared respectively.Results Hospitalization days and total hospitalization costs in DRG-1 group were lower than those in non-DRG group.Hospitalization days and total hospitalization costs in DRG-2 group were lower than those in DRG-1 group,and the differences were statistically significant(P<0.05).In the composition of hospitalization expenses,compared with non-DRG group,the proportion of medical material costs and nursing costs decreased,while the proportion of treatment costs,drug costs,diagnosis costs,medical service costs,operating costs and other expenses increased in DRG-1 group.Compared with the DRG-1 group,the proportion of medical material costs,treatment costs and drug costs decreased,while the proportion of diagnosis costs,medical service costs,operating costs,nursing costs and other costs increased in DRG-2 group.Conclusions DRG has a significant cost control effect on inpatients with unstable angina.The continuous implementation of DRG is conducive to the effective control of medical costs and optimizing the cost structure.

关 键 词：DRG 不稳定型心绞痛 控费效果 倾向性评分匹配 

分 类 号：R195[医药卫生—卫生统计学]