DRG支付方式改革对高血压患者住院次均费用的影响研究  

Analysis of the Influence of DRG Payment Reform on the Average Hospitalization Expense of Patients with Hypertension Disease

作　　者：葛龙[1] 张南[1] 王月[1] Ge Long;Zhang Nan;Wang Yue(The First Affiliated Hospital of Xinjiang Medical University,Urumqi,Xinjiang,830001,China)

机构地区：[1]新疆医科大学第一附属医院,新疆乌鲁木齐830001

出　　处：《中国医院管理》2023年第12期25-28,共4页Chinese Hospital Management

基　　金：新疆维吾尔自治区“青年科技人才-乡村振兴”项目(WJWY-XCZX202237);省部共建中亚高发病成因与防治国家重点实验室开放课题项目(SKL-HIDCA-2021-54);新疆维吾尔自治区医院管理研究所项目(ZZQYYGLYJS-202108B)。

摘　　要：目的分析按疾病诊断相关分组(DRG)支付方式改革对高血压患者住院次均费用水平和结构的影响,为医院精细化管理和完善医保支付政策提供参考。方法分别收集2020年9月—2021年8月、2021年9月—2022年8月新疆某三级甲等医院高血压患者住院费用信息,通过新灰色关联分析法与结构变动度分析住院费用内部结构变化情况。结果高血压患者住院次均费用显著下降;FV23、FV25病组住院次均费用结构变动度分别为25.42%、6.20%,检查费、化验费与住院次均费用关联序列位列第1、2位。FV23病组检查费、材料费、化验费和药品费结构变动度累积贡献率为95.94%,FV25病组化验费、治疗费结构变动度累积贡献率为69.03%。结论DRG支付方式改革后高血压患者住院次均费用得到有效控制,检查费和化验费仍是住院费用最主要的内部因素。合适的门诊统筹报销政策可提升医保基金支付效率。伴有合并症/并发症的患者住院费用结构合理性需重点关注。医务人员劳动价值需要进一步得到体现。Objective To analyse the impact of the reform of the payment method according to disease DRG on the level and structure of the average hospital inpatient costs of hypertensive patients,and to provide a reference for hospitals to fine-tune their management and improve their health insurance payment policies.Methods Data on the hospitalization expense of patients with hypertension was collected a Grade-III tertiary general hospital in Xinjiang Province during September 2020-August 2021 and September 2021-August 2022.The New gray correlation anglysis and Structural variation analysis were used to analyze the structural changes and mutual relationship of the average hospitalization expense.Results There is a significantly decrease on the average hospitalization expense of patients with hypertension.The structural variation degree of the average hospitalization expense in FV23 and FV25 were 25.42%and 6.20%respectively.The top two factors affecting the contribution rate of structural change were the inspection fee and clinical laboratory test fee.The cumulative contribution rate of the factors including inspection fee,materials fee,clinical laboratory fee and drugs fee was 95.94%in FV23.The cumulative contribution rate of clinical laboratory test fee and treatment fee was 69.03%in FV25.Conclusion The average hospitalization expense of patients with hypertension disease has been effectively controlled.The inspection fee and clinical laboratory test fee were still the main factors affecting the average hospitalization expense.The management mode of day care unit can improve the payment efficiency of medical insurance funds.It's necessary to pay attention to the cost that reflects the value of medical staff's technical labor service.

关 键 词：疾病诊断相关分组 高血压 新灰色关联分析法 结构变动度 

分 类 号：R197.322[医药卫生—卫生事业管理]