按病种付费对中医优势病种住院费用的影响研究——基于PSM-DID法  

Study the Impact of DRG on the Hospitalization Expenses of the Dominant Diseases of Traditional Chinese Medicine--Based on PSM-DID Method

作　　者：岳铭坤 李凯 黄娜 李青峰 杨土保[2] 周良荣 YUE Mingkun;LI Kai;HUANG Na;LI Qingfeng;YANG Tubao;ZHOU Liangrong(School of Humanities and Management,Hunan University of Chinese Medicine,Changsha Hunan 410208,China;不详)

机构地区：[1]湖南中医药大学人文与管理学院,湖南长沙410208 [2]中南大学湘雅公共卫生学院,湖南长沙410078

出　　处：《卫生经济研究》2024年第3期62-64,共3页

基　　金：湖南省中医药研发重大项目“湖南省医疗保障支持中医药传承创新发展政策研究”(A2022003);湖南省卫生经济与信息学会项目“价值医疗视角下中医优势病种的DRG付费研究”(2022B10);湖南中医药大学研究生创新课题项目“中医医院医疗配置效率研究——基于2009-2021年中部某省卫生统计数据”(2022CX21)。

摘　　要：目的:分析按病种付费对中医优势病种住院费用的影响,为中医按病种付费改革提供参考。方法:采用某中医医院实施按病种付费的高位肛瘘患者住院费用数据,经倾向得分匹配法(PSM)匹配后,进行双重差分(DID)回归分析,探讨按病种付费对中医优势病种住院费用的影响。结果:实施按病种付费后,高位肛瘘患者住院总费用下降了1067.63元、自付费用下降了656.66元、住院天数缩短了5.54天、西药费增长了406.55元、中成药费下降了126.80元。结论:在中医优势病种按病种付费过程中,应加强医保监督,持续完善、更新中医信息系统,扩大按病种付费的中医优势病种范围,突出中医临床路径优势,促进中医药传承创新发展。Objective To analyze the impact of DRG on the hospitalization expenses of the dominant diseases of traditional Chinese medicine,and to provide reference for the reform of DRG in traditional Chinese medicine.Methods The hospitalization expenses data of high anal fistula patients in a pilot traditional Chinese medicine hospital that implemented DRG were collected.After propensity score matching(PSM),double difference(DID)regression analysis was used to explore the impact of DRG on the hospitalization expenses of the dominant diseases of traditional Chinese medicine.Results After the implementation of DRG,the total hospitalization expenses of patients with high anal fistula decreased by 1067.63 yuan,the out-of-pocket expenses decreased by 656.66 yuan,the number of hospitalization days was shortened by 5.54 days,the cost of western medicines increased by 406.55 yuan,and the cost of Chinese patent medicines decreased by 126.80 yuan.Conclusion In the process of DRG for the dominant diseases of traditional Chinese medicine,it is necessary to strengthen medical insurance supervision,continuously improve and update Chinese medicine information system,expand the scope of the dominant diseases of traditional Chinese medicine with DRG,emphasize the advantages of the clinical pathway in traditional Chinese medicine,and promote the inheritance,innovation,and development of traditional Chinese medicine.

关 键 词：按病种付费 中医优势病种 住院费用 双重差分 倾向得分匹配法 

分 类 号：R197[医药卫生—卫生事业管理]