DRGs支付改革前后结直肠癌手术病例住院费用分析  

Analysis of Hospitalization Costs of Colorectal Cancer Surgery Cases before and after DRGs Payment Reform

作　　者：王明飞 李桂凤 梁杨 肖晓兰[2] WANG Mingfei;LI Guifeng;LIANG Yang;XIAO Xiaolan(Quality Control Department,Guilin Hospital of Chinese Traditional and Western Medicine,Guilin,Guangxi,541004;Medical Records Information Department,Guangxi Medical University Cancer Hospital&Guangxi Center Institute,Nanning,Guangxi,530021)

机构地区：[1]广西桂林市中西医结合医院质控科,广西桂林541004 [2]广西医科大学附属肿瘤医院病案信息科,广西南宁530021

出　　处：《江苏卫生事业管理》2023年第10期1400-1403,共4页Jiangsu Health System Management

基　　金：广西中医药管理局自筹经费科研课题(GXZYC20220511)。

摘　　要：目的:分析DGR支付模式对中医医院结直肠癌手术患者住院费用的影响,为进一步完善DRG改革方案提供有益的参考依据。方法:收集某市三甲中西医结合医院DGR支付改革前后结直肠癌手术病例的住院病案首页数据,统计比较2组病例年龄、性别、住院天数、例均费用等数据的差异。结果:与DRG支付改革前相比,改革后结直肠癌手术病例例均总费用由54017.67元下降到47077.32元,下降了12.85%,其中西药费下降明显,诊断费和其他类费用也有所下降;改革后结直肠癌手术病例的住院费用结构也发生变化,西药费、其他类费用占比下降,材料费占比上升明显,中医治疗费、手术治疗费、护理费和中药费占比有所上升,差异具有统计学意义。结论:DRG支付方式在中医医院的实践中减少了结直肠癌病例住院部分项目费用支出,从而降低了住院总费用,具有一定的代表性。Objective:To analyze the effect of DGR payment model on hospitalization costs of patients with colorectal cancer under-going surgery in traditional Chinese medicine hospitals,and provide useful reference basis for further improving DRG reform plan.Methods:The hospital discharge data of colorectal cancer surgery cases in acertain grade A tertiary combined Chinese and Western medicine hospital in a certain city before and after DGR payment reform were collected.The differences in age,gender,hospitalization days,average cost per case,and other data between the two groups were statistically compared.Results:Compared with before the DRG payment reform,the average total cost per case of colorectal cancer surgery cases decreased from 54,017.67 yuan to 47,077.32 yuan,a decrease of 12.85%after the reform.The cost of Western medicine decreased significantly,and the costs for diagnostic and oth-er categories also decreased to some extent.The structure of hospitalization costs of colorectal cancer surgery cases changed after the re-form,with the proportion of Western medicine and other categories decreasing,while the proportion of material costs increased signifi-cantly,and the proportions of Chinese medicine treatment,surgical treatment,nursing,and Chinese medicine costs increased to some extent.The differences were statistically significant.Conclusion:The DRG payment mode has played a role in reducing the partial project cost expenditure of colorectal cancer cases in traditional Chinese medicine hospitals,thereby reducing the total hospitalization costs,and has certain representativeness.

关 键 词：DRG 结直肠癌 手术病例 住院费用 

分 类 号：R197.1[医药卫生—卫生事业管理]