按病种付费模式在非血栓性疾病患者中的应用效果  

Application effect of payment by diagnosis related groups payment mode in patients with nonthrombotic diseases

作　　者：蔡丹丹 卢斌华 陈琳[1] CAI Dandan;LU Binhua;CHEN Lin(Department of Neurosurgery,Affiliated Jinhua Hospital,Zhejiang University School of Medicine,Zhejiang Province,Jinhua 321000,China)

机构地区：[1]浙江大学医学院附属金华医院神经外科,浙江金华321000

出　　处：《中国医药导报》2024年第15期33-35,共3页China Medical Herald

基　　金：浙江省医药卫生科技计划项目(2022PY099);浙江省金华市中心医院中青年科研启动基金项目(JY2021-3-03DRGS)。

摘　　要：目的 探讨按病种付费(DRGs)模式在非血栓性疾病患者中的应用意义及对治疗费用的影响。方法 收集2017年1月至2021年12月在浙江省金华市中心医院神经外科接受治疗的307例非血栓性疾病患者的一般资料,其中2017年1月至2019年6月就诊的154例患者为对照组,该组在治疗过程中采用常规付费模式,2019年7月至2021年12月就诊的153例患者为观察组,该组在治疗过程中采用DRGs模式。分析两组医疗费用,病种数量、C型、D型病例数量,平均住院时间等指标,研究DRGs模式对危重患者总费用的影响机制。结果 两组诊疗费比较,差异无统计学意义(P>0.05),观察组检查费、手术费、药费、耗材费、人均住院费低于对照组(P<0.05)。观察组C型、D型病例多于对照组,平均住院时间短于对照组(P<0.05);两组住院死亡例数比较,差异无统计学意义(P>0.05)。DRGs模式对药费、检查费耗材量的效应比较,差异有统计学意义(P<0.05),对手术费、诊疗费的效应比较,差异无统计学意义(P>0.05);DRGs模式对患者整体治疗开支的间接效应值为2 313.47,直接效应值为257.89。结论 引进DRGs模式有助于优化医院的成本控制,提高医疗技术,增强对疑难杂症的应对能力;同时可以通过精准治疗,降低患者的医疗开支,以减轻患者经济负担。Objective To explore the application significance of payment by diagnosis related groups(DRGs) model in patients with nonthrombotic diseases and its influence on treatment cost.Methods General data of 307 patients with nonthrombotic diseases who received treatment in the Department of Neurosurgery of Jinhua Central Hospital,Zhejiang Province from January 2017 to December 2021 were collected,among which 154 patients who received treatment from January 2017 to June 2019 were the control group,which was treated with routine payment mode during treatment.A total of 153 patients treated between July 2019 and December 2021 were in the observation group,which was treated with DRGs mode.The hospitalization costs,number of diseases,the number of type C and type D cases,the average length of hospital stay,and other indicators of the two groups were analyzed,and the mechanism of the influence of DRGs mode on the total cost of critically ill patients was studied.Results There was no significant difference in diagnosis and treatment fee between the two groups(P>0.05).The inspection fee,operation fee,medicine fee,consumables fee,and per capita hospitalization fee in the observation group were lower than those in the control group(P<0.05).The number of patients with type C and type D in the observation group was higher than that in the control group,and the average hospitalization time was shorter than that in the control group(P<0.05).There was no significant difference in the number of in-hospital deaths between the two groups(P>0.05).Comparison of direct effect of DRGs mode on medicine fee and inspection fee showed statistical significance(P<0.05),while comparison of direct effect on operation fee and diagnosis and treatment fee showed no statistical significance(P>0.05).The indirect effect value of DRGs model on the total treatment expenditure of patients was 2 313.47,and the direct effect value was 257.89.Conclusion The introduction of DRGs model is helpful to optimize hospital cost control,improve medical technology,and s

关 键 词：按病种付费模式 非血栓性疾病 住院费用 住院时间 结构等式模型 

分 类 号：R197.1[医药卫生—卫生事业管理]