公立医院科室绩效方案改革对DIP患者住院费用影响——基于中断时间序列分析  

Influence of the Reform of Public Hospital Department Performance Scheme on the Hospitalization Expenses of DIP Patients:Analysis Based on Interruption Time Series

作　　者：陈丽丽 王超群[2] 杨莹[3] 曾智贤 郑勇生 Chen Lili;Wang Chaoqun;Yang Ying(Wengyuan People's Hospital,Wengyuan,Guangdong,512600,China;不详)

机构地区：[1]广东省翁源县人民医院,广东翁源512600 [2]华中师范大学公共管理学院,湖北武汉430079 [3]华中科技大学同济医学院护理学院,湖北武汉430030

出　　处：《中国医院管理》2024年第5期36-39,共4页Chinese Hospital Management

基　　金：韶关市卫生健康科研项目(Y23159)。

摘　　要：目的 探讨医保按病种分值付费(Diagnosis-Intervention Packet,DIP)背景下公立医院科室绩效方案改革对DIP患者住院费用的影响,为优化公立医院科室绩效管理制度、降低DIP患者住院费用提供参考。方法 收集广东省某县级人民医院2020年7月—2023年7月DIP患者的住院费用数据,采用中断时间序列分析法描述例均住院费用变化趋势,分析该院科室绩效方案改革对DIP患者住院费用的影响。结果 医院科室绩效方案改革后,DIP患者总费用下降1 071.93元,并且每月继续下降116.39元。同时,科室绩效方案改革主要对居民医保DIP患者发挥作用,对职工医保DIP患者没有明显影响。结论 公立医院科室绩效方案改革明显降低了DIP患者的总费用及其分项费用,但是对不同险种DIP患者的影响不同。应进一步完善公立医院科室绩效管理机制,建立与医疗效能、医疗质量等相关的多维度绩效考核指标体系,因地制宜推动公立医院科室绩效方案改革,促进公立医院高质量发展。Objective To explore the influence of the reform of public hospital department performance scheme on the hospitalization expenses of patients with medical insurance Diagnosis-Intervention Packet(DIP),and to provide evidences for optimizing the public hospital performance management system and reducing the hospitalization expenses of DIP patients.Methods The data of hospitalization expenses of DIP patients from July 2020 to July 2023in a county-level people's hospital in Guangdong Province were collected,and the changing trend of hospitalization expenses was described by means of interrupted time series analysis,and the influence of performance plan reform on hospitalization expenses of DIP patients was analyzed.Results After the performance reform,the total expenses of DIP patients immediately decreased by 1071.93 yuan,and continued to decrease by 116.39 yuan per month.At the same time,the performance reform mainly plays a role in residents'medical insurance DIP patients,but has no significant effect on employees'medical insurance DIP patients.Conclusion The performance reform has significantly reduced the total expenses of DIP patients and their sub-expenses,but it has different effects on patients with different types of insurance.It should further improve the performance management mechanism of public hospitals,establish a multi-dimensional performance evaluation index system related to medical efficiency and medical quality,promote the performance reform according to local conditions,and promote the high-quality development of public hospitals and so on.

关 键 词：公立医院 科室绩效方案改革 按病种分值付费 住院费用 中断时间序列分析 

分 类 号：R197.322[医药卫生—卫生事业管理]