CHS-DRG付费方式改革对某院肺癌胸腔镜手术患者住院费用的影响分析  

Analysis on the Impact of CHS-DRG Payment Method on Hospitalization Expenses of Lung Cancer Patients Undergoing Thoracoscopic Surgery in a Hospital

作　　者：赵宁 单丽敏[1] 卢晓艳 夏广惠[1] 胡婉筠 Zhao Ning;Shan Limin;Lu Xiaoyan;Xia Guanghui;Hu Wanyun(Nanjing Chest Hospital,Nanjing 210029,Jiangsu Province,China;不详)

机构地区：[1]南京市胸科医院,江苏省南京市210029

出　　处：《中国病案》2024年第10期72-75,共4页Chinese Medical Record

基　　金：2023年江苏省卫生健康财务研究课题(CW202301);2022年度南京市卫生科技发展专项资金项目(GBX22295)。

摘　　要：目的探讨CHS-DRG付费方式改革实施前后肺癌胸腔镜手术患者住院费用的变化,为合理控制医疗费用、减轻患者疾病负担提供依据。方法提取南京市某三级医院CHS-DRG付费改革前2021年1月1日-2021年12月31日肺癌胸腔镜手术患者1779例(改革前),和CHS-DRG付费改革后2022年1月1日-2022年12月31日肺癌胸腔镜手术患者1382例(改革后),共3161例数据,导入Excel2017数据库,并运用SPSS 27.0统计软件对CHS-DRG付费实施前后各组数据进行描述与推断统计分析。结果改革后住院日缩减,住院费用降低:改革前平均住院日8.59天,改革后平均住院日7.63天;住院费用在改革后明显下降:次均费用下降了4862.29元(7.29%)、手术材料费下降3422.13元(12.90%)、药品费减少1659.30元(9.05%)、检查检验费下降1502.67元(13.38%);手术费上升1474.77元(21.96%)、治疗费上升213.65元(7.81%)。经检验,各组费用数据符合正态分布,且改革前后各项费用差异具有统计学意义。住院费用构成比中,改革后手术材料费、药费、检查检验费构成比均下降,分别下降了2.41%、0.52%、1.11%;同时,手术费、治疗费占比均上升,分别上升3.18%、0.67%。结论改革后肺癌胸腔镜手术患者次均费用、手术材料费、药品费及检查检验费有效降低,医疗费用控制取得一定效果,医疗费用结构得到一定优化,一定程度上减轻了患者疾病负担;同时,优化医疗费用结构方面仍有调整空间。Objectives To discuss the changes of hospitalization expenses of patients undergoing thoracoscopic surgery for lung cancer before and after CHS-DRG payment method,so as to provide a basis for reasonable control of medical expenses and reduction of patients'disease burden.Methods A total of 3161 cases of patients undergoing thoracoscopic surgery were extracted in a tertiary hospital in Nanjing from January 1st,2021 to December 31st,2021 before CHS-DRG payment method(1779 cases)and from January 1st,2022 to December 31st,2022 after CHS-DRG payment method(1382 cases).The data were imported into the Excel 2017 database,and SPSS 27.0statistical software was used to perform descriptive and inferential statistical analysis on each group of data before and after the implementation of CHS-DRG payment.Results CHS-DRG payment could reduce the length of stay of patients undergoing thoracoscopic surgery for lung cancer:the average length of stay before CHS-DRG payment was 8.59 days,and the average length of stay after CHS-DRG payment was 7.63 days.The hospitalization expenses of patients undergoing thoracoscopic surgery for lung cancer after CHS-DRG implementation were significantly lower than those before CHS-DRG implementation:the average cost per time decreased by 4862.29 Yuan(decreased by 7.29%),the cost of surgical materials decreased by 3422.13 Yuan(decreased by 12.90%),the cost of drugs decreased by 1659.30 Yuan(decreased by 9.05%),and the cost of inspection decreased by 1502.67Yuan(decreased by 13.38%);the operation cost increased by 1474.77 Yuan(21.96%),and the treatment cost increased by 213.65 Yuan(7.81%).Normal distribution test was performed for each group and t-test was used to analyze each group,and the results showed that the difference was statistically significant.In the proportion of hospitalization expenses,the proportion of surgical materials,medicine and inspection fees decreased by 2.41%,0.52%and 1.11%respectively after CHS-DRG payment.At the same time,the proportion of surgical expenses and treatment ex

关 键 词：疾病诊断相关分组 肺癌 胸腔镜手术 住院费用 

分 类 号：R734.2[医药卫生—肿瘤] R197.3[医药卫生—临床医学]