基于价值医疗的某医院精细化诊疗组服务现状分析  

Current Situation and Consideration of Refinement of Hospital Team Service based on Value-based Medicine

作　　者：段俊 易黎[1] 陈寒杰 刘畅[1] 刁予涵 刘海燕 何桂香[1] 梅婧[1] 刘颜[1] 陈芸[1] Duan Jun;Yi Li;Chen Hanjie(Peking University Shenzhen Hospital,Shenzhen,Guangdong,518036,China;不详)

机构地区：[1]北京大学深圳医院,广东深圳518036

出　　处：《中国医院管理》2024年第2期63-66,共4页Chinese Hospital Management

基　　金：深圳市“三名工程”资助项目(SZSM201812088);深圳市卫生经济学会科研基金项目(202304)。

摘　　要：目的描述某医院4个同类型科室诊疗组现状并展开分析,为“最高性价比医疗”建设提供依据。方法采用CN-DRG比较诊疗组的医疗能力和住院服务效率,纳入DRG病组原位癌和非恶性病损子宫手术、单病种子宫肌瘤,采用Kruskal-Wallis H检验,比较住院日和费用差异。结果研究纳入22630例患者,诊疗组1总权重最高,为3948.62;诊疗组11最低,为133.55。诊疗组5费用消耗指数最低,为0.89;诊疗组2最高,为1.04。诊疗组11时间消耗指数最低,为0.48;诊疗组5最高,为0.81。在诊疗组对比中,住院日、总费用、诊断费、治疗费和耗材费差异均有统计学意义(P<0.05);在科室内部诊疗组对比中,科室1和2的住院日和费用差异均有统计学意义(P<0.05),科室3的诊断费、治疗费和耗材费差异均有统计学意义(P<0.05)。结论各诊疗组的服务能力对医院的贡献有明显差别且费用有差异,需合理评估患者住院时长和医疗成本,以实现最高性价比医疗。Objective To describe and analyze the current situation of the four same type of departments in an hospital in order to provide a reference for the construction of“the most cost-effective medical care”.Methods The CN-DRG were used to automatically group and compare the medical capacity and inpatient service efficiency of the hospital department groups,and in the refined analysis,one DRG disease group of in situ cancer and nonmalignant disease loss uterine surgery and single species uterine fibroid was included,and the Kruskal-Wallis H test was used to further compare the differences in length of stay and various costs.Results It included a total of 22630 patients,whose weights varied from a maximum of 3948.62 in diagnostic group 1 to a minimum of 133.55 in diagnostic group 11.The cost consumption indexes ranged from a minimum of 0.89 in diagnostic group 5 to a maximum of 1.04 in diagnostic group 2,while the time consumption indexes ranged from a minimum of 0.48 in diagnostic group 11 to a maximum of 0.81 in diagnostic group 5.When comparing the diagnostic groups,there were statistically significant differences(P<0.05)in hospitalization days,total cost,diagnostic cost,therapeutic cost,and cost of supplies.Specifically,when comparing the diagnostic and treatment groups within departments,the differences in hospitalization days and all costs were statistically significant(P<0.05)in departments 1 and 2,the differences in diagnostic cost,therapeutic cost,and cost of supplies were statistically significant(P<0.05)in department 3.Conclusion There exists a notable disparity in the extent to which each diagnostic and treatment group contributes to the hospital’s service capacity and cost variability.Consequently,it is necessary to reasonably evaluate the length of hospital stay and medical cost of patients to achieve the highest cost-effective medical treatment.

关 键 词：诊疗组 价值医疗 单病种 疾病诊断相关分组 

分 类 号：R197.323.2[医药卫生—卫生事业管理]