DRG付费下甲状腺癌大手术患者支付差影响因素分析  

Analysis of the Influencing Factors of Payment Difference in Thyroid Cancer Patients Undergoing Major Surgery Under the DRG payment

作　　者：林振威 吴风琴[1] 程斌[1] 王锦毓 陈洁 

机构地区：[1]浙江省肿瘤医院,杭州310022 [2]浙江省省级医院管理中心,杭州310002

出　　处：《中国医疗保险》2024年第5期80-84,共5页China Health Insurance

基　　金：2022年浙江省卫生健康科技计划“基于门诊病例分组(APG)的支付标准测定及费用控制研究”(2022KY141);2022年浙江省医学会临床医学科研专项资金项目“便民医保服务平台的开发”(2022ZYCZ14)。

摘　　要：目的:分析疾病诊断相关分组(DRG)付费下甲状腺癌大手术患者支付差的影响因素,为医院合理控制医疗成本提供参考。方法:选取某三甲医院2020—2022年所有甲状腺癌大手术组(KD1)患者作为研究对象,利用描述性统计、单因素方法和二分类Logistic回归分析患者支付差的影响因素。结果:住院天数、并发症与合并症、手术部位、是否颈清、是否腔镜、药品占比、耗材占比和手术占比是影响甲状腺癌大手术患者支付差的主要因素。结论:DRG改革下,医院应推广价值医疗的理念,促进临床规范诊疗,并加强病案质量审核,保证DRG正确入组,在此基础上合理调整费用结构,科学管控药耗成本,助力医院高质量发展。Objective:The paper analyzes the factors that influence the payment difference of thyroid cancer patients undergoing major surgery under the background of DRG reform,and provide references for hospitals to control their medical costs reasonably.Methods:All patients in the thyroid cancer major surgery group(KD1)of a tertiary hospital from 2020 to 2022 were selected as the research subjects.Descriptive statistics,univariate methods,and binary logistic regression were used to analyze the factors that influence the payment difference of patients.Results:Hospitalization days,complications and comorbidities,surgical site,neck dissection,laparoscopy,drug proportion,material proportion,and surgery proportion are the main factors affecting the payment difference of patients undergoing major thyroid cancer surgery.Conclusions:Under the DRG reform,hospitals should publicize the concept of value-based medical care,promote clinical standardized diagnosis and treatment,and strengthen the quality review of medical records to ensure the correct grouping of DRG.Moreover,they should adjust the cost structure reasonably,control the drug and material consumption scientifically,in order to facilitate the high-quality development of hospitals.

关 键 词：疾病诊断相关分组 支付差 甲状腺癌 住院费用 

分 类 号：F840.684[经济管理—保险]