基于DRG的胃癌患者分组效果及住院费用影响因素分析  

Analysis of Grouping Effect of Gastric Cancer Patients and Influencing Factors of Hospitalization Cost based on DRG

作　　者：董旭强 苏芮 柴熙 万斌 王光锋 高冲 车成业[1] 孟冬梅[1] Dong Xuqiang;Su Rui;Chai Xi(Affliated Hospital of Qingdao University,Qingdao,Shandong,266000,China;不详)

机构地区：[1]青岛大学附属医院,山东青岛266000

出　　处：《中国医院管理》2024年第9期70-74,共5页Chinese Hospital Management

摘　　要：目的分析按疾病诊断相关分组(DRG)付费下胃癌患者分组效果及住院费用影响因素,为DRG付费改革提供参考。方法采用变异系数(Coefficient of Variation,CV)和总体方差减少系数评价DRG分组效果;采用结构变动值和结构变动度分析不同DRG组住院费用结构变动情况,通过灰色关联度分析计算次均住院费用的关联程度;采用非参数检验和多元线性回归分析住院费用的影响因素。结果DRG分组效果不佳,组间异质性不够明显;住院费用结构不合理,耗材费占比过高,排在住院费用灰色关联度首位,综合医疗服务费、治疗费分别排在第三、五位;影响住院费用的主要因素是治疗方式、住院日、是否伴有并发症、是否首次住院,差异有统计学意义(P<0.05)。结论应增加分组节点或提高CV标准,增强胃癌DRG分组效果;优化住院费用结构,体现医务人员劳动和技术价值;加强内部管理,控制不合理药品、耗材使用。Objective Analyzes the grouping effect and its influencing factors under DRG payment,provides reference for the reform of DRG payment.Methods Evaluates the effectiveness of DRG grouping using Cofficient of Variation(CV)and Reduction in Variance;using Value of Structure of Variation and Degree of Structure Variation,analyzes hospitalization costs structure changes of different DRG groups,and calculates the degree of correlation between average hospitalization costs through grey relational analysis;using non parametric tests and multiple regression to analyze the influencing factors of hospitalization cost.Results DRG grouping effect was not good,inter-group heterogeneity was not obvious;the structure of hospitalization expenses is unreasonable,and the proportion of consumables expenses is too high,ranking first in the grey correlation degree of hospitalization expenses,comprehensive medical service fees and treatment fees rank third and fifth respectively;the main factors affecting hospitalization costs are treatment methods,length of stay,presence of complications,and first hospitalization,the difference is statistically significant(P<0.05).Conclusion More grouping nodes or higher CV value standards should be added to enhance the grouping effect of gastric cancer DRG;optimize the structure of hospitalization costs to reflect the labor and technical value of medical personnel;strengthen internal management and control the unreasonable use of drugs and consumables.

关 键 词：疾病诊断相关分组 胃癌 分组效果 住院费用 

分 类 号：R197.323.2[医药卫生—卫生事业管理]