DRG付费对中医骨伤技术的影响——以治疗桡骨骨折患者为例  

Impact of DRG payment on orthopedics and traumatology in Chinese medicine-a case study of patients with distal radius fracture

作　　者：邱静 万琳[1] 王雯璟 戴燚[1] QIU Jing;WAN Lin;WANG Wenjing;DAI Yi(Wuhan Hospital of Traditional Chinese Medicine,Wuhan Hubei 430014,China)

机构地区：[1]武汉市中医医院,湖北武汉430014

出　　处：《卫生软科学》2024年第8期1-4,共4页Soft Science of Health

基　　金：湖北省中医药管理局中医药科研项目(ZY2021M013)。

摘　　要：[目的]以桡骨骨折为例,分析现行的DRG付费模式对中医骨伤技术的影响。[方法]以湖北省某三级甲等中医医院2021-2022年出院的101例A型、B型桡骨骨折患者为研究对象,根据手术方式分为中医骨伤技术组和西医手术组,分析两组的例均费用、DRG权重、DRG支付标准和盈亏情况。[结果]中医骨伤技术组的住院总费用(12742.58元)、DRG权重(0.46)、DRG支付标准(5259.18元),均低于西医手术组的住院总费用(33613.97元)、DRG权重(3.20)、DRG支付标准(35805.00元),差异有统计学意义(P<0.05)。中医骨伤技术组在医保补偿前盈亏为-2540.14元,医保补偿后盈亏为-1151.14元,均为亏损状态。西医手术组在医保补偿前后盈亏均为4432.18元,为盈利状态。医保补偿前后,两组盈亏情况差异均有统计学意义(P<0.05)。[结论]现行的DRG分组未能赋予中医骨伤技术合理的权重值,造成中医骨伤技术组与西医手术组“同病同效却不同价”,导致中医骨伤技术的应用在DRG付费中处于很大的劣势。因此,探索出适合中医医院的独立付费方式已经迫在眉睫。Objective This paper analyzes the impact of the current DRG payment on orthopedics and traumatology in TCM by taking distal radius fracture as an example.Methods A total of 101 patients with distal radius fracture(AO classification:type A,type B)discharged from a tertiary first-class TCM hospital in Hubei Province from 2021 to 2022 were selected as the research object.The patients were divided into the orthopedics and traumatology in TCM group and the western medicine surgery group according to the surgical methods.The average cost per case,DRG weight,DRG payment standard,and profit and loss of the two groups were analyzed.Results The total hospitalization expenses(12742.58 yuan),DRG weight(0.46),and DRG payment standard(5259.18 yuan)of the orthopedics and traumatology in TCM group were lower than the total hospitalization expenses(33613.97 yuan),DRG weight(3.20),and DRG payment standard(35805.00 yuan)of western medicine surgery group,with statistically significant differences(P<0.05).The profit and loss of the orthopedics and traumatology in TCM group was-2540.14 yuan before medical insurance compensation,and the profit and loss of the orthopedics and traumatology in TCM group was-1151.14 yuan after medical insurance compensation,both of which were in a state of loss.The profit and loss of the western medicine surgery group before and after medical insurance compensation both were 4432.18 yuan,indicating a profitable state.The difference between profit and loss of two groups before and after medical insurance compensation was statistically significant(P<0.05).Conclusions The current DRG grouping fails to assign a reasonable weight value to the orthopedics and traumatology in TCM,resulting in the“same disease with same therapeutic effect but different costs”between the orthopedics and traumatology in TCM group and the western medicine surgery group,which causes a significant disadvantage of the application of the orthopedics and traumatology in TCM in DRG payment.Therefore,it is urgent to explore an independe

关 键 词：DRG付费 中医骨伤技术 桡骨骨折 

分 类 号：R194[医药卫生—卫生事业管理]