DRG对住院患者医疗费用和中医服务利用的影响——以某三甲中医院为例  

The Impact of DRG on the Medical Expenses of Inpatients and the Utilization of Traditional Chinese Medicine Services——Taking a Tertiary Traditional Chinese Medicine Hospital as an Example

作　　者：夏思睿 戚雅婷 徐姗姗 高月霞[1] 

机构地区：[1]南通大学公共卫生学院,南通226019

出　　处：《中国医疗保险》2024年第7期102-108,共7页China Health Insurance

摘　　要：目的:评价DRG支付方式改革对中医院住院患者医疗费用和中医服务利用的影响。方法:采用改革前后的对比研究设计,收集改革前、后12个月N市Z医院508例出院患者的病案首页资料,运用倾向性评分匹配法分析DRG改革对住院费用及中医服务利用的影响。结果:DRG改革后,三个病种的次均住院费用均有所下降,西药费与耗材费呈现下降趋势,中医类费用显著增加,中医设备使用率上升了23.38%。多因素回归表明,DRG改革后的次均住院费用降低了35%,DRG改革和住院天数是影响次均住院费用的重要因素。结论:DRG改革降低了住院费用,提高了中医服务利用。应规范中医治疗的临床路径,促进中医药服务合理使用。Objective:The paper evaluates the effect of DRG payment method reform on the medical expenses of inpatients in traditional Chinese medicine(TCM)hospitals and the utilization of TCM services.Methods:A pre-post study design was conducted and the data of 508 discharged patients was collected from the first page of medical records in Z Hospital in N City 12 months before and after the reform.Propensity score matching method was used to analyzed the effect of DRG reform on hospitalization cost and TCM service utilization.Results:After the implementation of DRG reform,the total inpatient cost of the three diseases decreased,the cost of western medicine and consumables showed a downward trend,the cost of TCM increased significantly,and the utilization rate of TCM equipment increased by 23.38%.Multivariate regression showed that the average hospitalization cost decreased by 35%after the implementation of DRG reform,and the DRG reform policy and length of stay are important factors affecting the average hospitalization cost.Conclusion:DRG reform decreased inpatient costs and increased the use of TCM services.Clinical pathways for TCM treatment should be strengthened to promote rational use of TCM services.

关 键 词：DRG 倾向得分匹配法 次均住院费用 中医服务利用 

分 类 号：F840.684[经济管理—保险] C913.7[社会学]