安徽省某三甲医院DRG付费改革效果评价  

Evaluation on the effect of DRG payment reform in a tertiary hospital in Anhui Province

作　　者：冯夕秋[1] 华小果 赵晨晨[1] 吴雪枫 马元新 孙谦 FENG Xiqiu;HUA Xiaoguo;ZHAO Chenchen;WU Xuefeng;MA Yuanxin;SUN Qian(Medical Insurance Administration Office,The Second Hospital of Anhui Medical University,Hefei Anhui 230601,China)

机构地区：[1]安徽医科大学第二附属医院医疗保险管理办公室,安徽合肥230601

出　　处：《卫生软科学》2024年第5期1-3,15,共4页Soft Science of Health

基　　金：2022年安徽医科大学校科研基金(2022xkj316)。

摘　　要：[目的]评价安徽省某三甲医院DRG付费改革的实施效果。[方法]收集2020-2022年某三甲医院DRG病例资料,比较住院费用、住院天数、内外科病例构成、正常倍率组占比及各项住院费用指标在3个年度之间的差异。[结果]与2020年相比,该院2021年、2022年的总费用、材料费、检查费、药品费、住院天数的中位数明显下降,差异均有统计学意义(P<0.05);与2021年相比,2022年内科病例占比及正常倍率组占比提高,差异均有统计学意义(P<0.05)。[结论] DRG付费改革倒逼医疗机构控制医疗费用不合理增长,优化费用结构,提升医疗服务效率,有利于推进分级诊疗。Objective To evaluate the implementation effect of DRG payment reform in a tertiary hospital in Anhui Province.Methods Data of DRG cases in a tertiary hospital from 2020 to 2022 were collected,and the differences of hospitalization cost,length of stay,composition of medical and surgical cases,the proportion of normal rate group,and indexes of various hospitalization cost in three years were compared.Results Compared with 2020,the median of total cost,material cost,checkup cost,drug cost and length of stay in 2021 and 2022 decreased significantly,and the differences were statistically significant(P<0.05).Compared with 2021,the proportion of medical cases in 2022 and the proportion of normal rate group increased,and the differences were statistically significant(P<0.05).Conclusions The DRG payment reform forces medical institutions to control the unreasonable growth of medical expenses,optimize the cost structure,improve the efficiency of medical services,and promote hierarchical diagnosis and treatment.

关 键 词：按疾病诊断相关分组 运营管理 医疗费用 

分 类 号：R195[医药卫生—卫生统计学]