DRG精细化管理助力公立医院高质量发展研究——基于A医院胸部大手术组的实证分析  

Study on DRG Refined Management Promoting High-quality Development of Public Hospitals——Empirical Analysis based on Major Thoracic Surgery(EB1)in Hospital A

作　　者：冯海欢[1] 崔欢欢 王晓昕 李天俊[1] 李耘天 FENG Haihuan;CUI Huanhuan;WANG Xiaoxin;LI Tianjun;LI Yuntian(West China Hospital of Sichuan University,Chengdu Sichuan 610041,China;不详)

机构地区：[1]四川大学华西医院,四川成都610041

出　　处：《卫生经济研究》2023年第11期12-15,共4页

基　　金：四川省科技厅重点研发项目“丙型病毒性肝炎诊疗方案综合评价及全程化‘预防-诊疗-支付’模型的建立研究”(2021YFS0145)。

摘　　要：目的:选择某综合性医院2018—2020年胸部大手术组(EB1)住院患者进行CHS-DRG分组模拟、费用测算和盈亏分析,为建立公立医院精细化管理体系、实现高质量发展提供实证依据。方法:以CHS-DRG分组逻辑为基础,结合“国考”指标导向,应用多元线性归回模型筛选患者医疗费用的影响因素,细化分组并分析超支原因。结果:EB1组可细分为35个病组,超支病例的分布具有特征性。结论:公立医院可综合考虑多种因素细化DRG分组颗粒度,推行标杆管理的质效评价,基于成本测算盈余,真正助力医院高质量发展。Objective To study the CHS-DRG grouping simulation,cost calculation,and profit and loss analysis of inpatients in the thoracic major surgery group(EB1)in a comprehensive hospital from 2018 to 2020,and to provide empirical evidence for establishing a refined management system for public hospitals and achieving high-quality development.Methods Based on the grouping logic of the CHS-DRG and guided by the performance evaluation of national tertiary public hospitals,a multiple linear regression model was applied to screen the influencing factors of inpatient medical expenses,and the grouping was refined and the reasons for overspending were analyzed.Results EB1 group could be subdivided into 35 disease groups.The distribution of overspending cases shows obvious characteristics.Conclusion In order to promote high-quality development,public hospitals should comprehensively consider various factors to refine DRG grouping,implement quality and efficiency evaluation of benchmark management,and calculate surplus based on cost.

关 键 词：疾病诊断相关分组 精细化管理 高质量发展 公立医院 

分 类 号：F840.684[经济管理—保险]