疾病诊断相关分组实施后赣州市高血压患者住院费用变化的中断时间序列分析  

Interrupted Time Series Analysis of Changes in Hospitalization Costs of Hypertensive Patients in Ganzhou City after the Implementation of Disease Diagnosis-related Grouping

作　　者：朱金云 陈一君 陈燕 张静华[4] Zhu Jinyun;Chen Yijun;Chen Yan;Zhang Jinghua(Department of Management,School of Business,Macao University of Science and Technology,Department of Elderly Health,Jiangxi Ganzhou Municipal Health Commission,Ganzhou 341000,Jiangxi Province,China;Department of Government and Public Administration,Faculty of Social Sciences,University of Macao,Macao 999078,China;Department of Sport and Recreation,School of Sport and Recreation,Sichuan Tourism University,Chengdu 610100,Sichuan Province,China;Department of Accounting and Finance,School of Business,University of Science and Technology of Macao4,Macao 999078,China)

机构地区：[1]澳门科技大学商学院管理学系,江西省赣州市卫生健康委老龄健康科,江西赣州341000 [2]澳门大学社会科学学院政府与公共行政学系,中国澳门999078 [3]四川旅游学院运动与休闲学院运动与休闲学系,四川成都610100 [4]澳门科技大学商学院会计与财务金融系,中国澳门999078

出　　处：《中外医药研究》2023年第18期159-161,共3页JOURNAL OF CHINESE AND FOREIGN MEDICINE AND PHARMACY RESEARCH

摘　　要：目的:分析实施疾病诊断相关分组(DRG)政策对高血压患者住院费用产生的影响。方法:选取2017年9月—2021年11月江西省赣州市20所医院(二级医院13所,三级医院7所)收治的高血压患者25502例作为研究对象,应用中断时间序列分析的方法分析DRG对高血压患者住院费用的影响,观测值是高血压患者月度平均住院费用。结果:DRG政策实施后,高血压患者月均住院费用的平均数减少,从实施前的4782.32元下降至4606.29元,差异有统计学意义(P=0.028);患者的月均住院费用总体呈现下降趋势。实施DRG后,高血压患者的月均住院费用显著增加了396.30元,斜率变化量β3=54.64,差异有统计学意义(P=0.003);政策实施后的直线斜率为-1.82。二级医院和三级医院的月均住院费用有短期上升,但长期来看二者呈现平缓下降的趋势,观测长期趋势的系数,二级医院具备显著性,三级医院前后对比无明显变化。结论:DRG政策实施前后的住院费用下降,提示该方式在一定程度上给试点范围医院的高血压患者减轻医疗经济负担,但部分地区依然存在改进空间,需要不断调整。Objective:To analyze the impact of the implementation of the disease diagnosis-related grouping(DRG)policy on the hospitalization costs of hypertensive patients.Methods:Twenty-five thousand five hundred and two cases of hypertensive patients admitted to 20 hospitals(13 secondary hospitals and 7 tertiary hospitals)in Ganzhou City,Jiangxi Province,from September 2017 to November 2021 were selected as the study population.The application of interrupted time series analysis was used to analyze the effect of DRG on the hospitalization cost of hypertensive patients,and the observed value was the average monthly hospitalization cost of hypertensive patients.Results:After the implementation of the DRG policy,the mean monthly average hospitalization cost of hypertensive patients decreased from 4,782.32 yuan before the implementation to 4,606.29 yuan,and the difference was statistically significant(P=0.028);Patients'average monthly hospitalization costs showed an overall decreasing trend;After the implementation of the DRG,the average monthly hospitalization cost for hypertensive patients significantly increased by 396.30 yuan,with a slope change ofβ3=54.64,a statistically significant difference(P=0.003);The linear slope after the policy implementation was-1.82;There is a short-term increase in the average monthly hospitalization costs of secondary and tertiary hospitals,but in the long term both show a gentle downward trend,observing the coefficient of the long-term trend,secondary hospitals possessed significance,and tertiary hospitals had no significant change in the before-and-after comparison.Conclusion:The decrease in hospitalization costs before and after the implementation of the DRG policy suggests that this approach has reduced the financial burden of medical care for hypertensive patients in the pilot hospitals to a certain extent,but there is still room for improvement in some areas,which requires continuous adjustment.

关 键 词：疾病诊断相关分组 高血压 住院费用 中断时间序列分析 

分 类 号：R47[医药卫生—护理学]