糖尿病患者DRG分组效果及住院费用影响因素分析  

Analysis of DRG grouping effect and influential factors of hospitalization cost of diabetic patients

作　　者：聂晓静[1] 付豪斐 白荷荷[1] 李亚萍[2] 王金萍[1] NIE Xiaojing;FU Haofei;BAI Hehe;LI Yaping;WANG Jinping(Dept.of Pharmacy,Xi’an Central Hospital,Xi’an 710003,China;Dept.of Quality Control,Xi’an Central Hospital,Xi’an 710003,China)

机构地区：[1]西安市中心医院药剂科,西安710003 [2]西安市中心医院质控科,西安710003

出　　处：《中国药房》2023年第24期3020-3024,共5页China Pharmacy

基　　金：西安市卫生健康委员会面上培育项目(No.2023ms01)。

摘　　要：目的探讨糖尿病疾病诊断相关分组(DRG)的分组效果及住院费用控制的影响因素,为完善DRG付费体系、降低医疗费用、提高医保基金使用效能提供依据。方法回顾性分析2021年1月1日至2023年6月30日西安市某三级甲等医院住院治疗的4368例糖尿病患者的病案信息,汇总其DRG分组情况,采用单因素方差分析和Bonferroni多重比较分析不同DRG分组患者的住院费用,采用变异系数(CV)评价组内异质性,采用单因素线性回归分析和多元线性回归分析探讨影响住院费用的因素。结果与结论4个DRG组患者住院费用的CV值均小于0.8,分组结果较好且组内一致性较好;4组患者住院费用比较差异有统计学意义,且国家医疗保障局DRG1.1版FW11组患者的住院费用显著高于其他3组(P<0.05)。住院天数、药品费用、其他诊断数量、检验费用和付款方式对糖尿病患者的住院费用有显著正向影响;是否有药师干预对患者的住院费用有显著负向影响。在DRG支付方式下,医疗机构可考虑多学科联动,纳入包括药师干预在内的多种管理和服务工具,制定精细化管理措施,从而降低患者家庭和社会的经济负担。OBJECTIVE To explore the grouping efficacy of diagnosis related group(DRG)and the influential factors of hospitalization cost in diabetes cases,and to provide theoretical support for improving DRG payment system,reducing medical cost and enhancing the efficiency of medical insurance funds.METHODS The information of 4368 diabetic patients who were hospitalized in a 3A hospital in Xi’an from January 1,2021 to June 30,2023 was retrospectively analyzed,and DRG grouping of them was summarized;the hospitalization costs of patients in different DRG groups were analyzed by using one way ANOVA and Bonferroni multiple comparison.Coefficient of variation(CV)was used for evaluation within the group,and the influential factors of hospitalization costs were analyzed by one-way linear regression analysis and multi-factor linear regression analysis.RESULTS&CONCLUSIONS The CV values of the four DRG groups were all lower than 0.8,indicating good grouping results and good consistency within the group;the difference of hospitalization cost among the four groups was statistically significant(P<0.05),and the hospitalization cost of China Healthcare Security-DRG version 1.1 FW11 group was significantly higher than those of other three groups(P<0.05).Length of stay,drug cost,the number of other diagnoses,test cost and payment method have significant positive effects on the hospitalization cost of diabetic patients.Whether there is pharmacist intervention has a significant negative influence on the hospitalization cost of patients.Under the DRG payment method,medical institutions can consider multidisciplinary linkage and incorporate a variety of management and service tools,including pharmacist’s intervention,to develop refined management measures,to reduce the economic burden of patients’families and society.

关 键 词：疾病诊断相关分组 糖尿病 住院费用 影响因素 

分 类 号：R95[医药卫生—药学]