基于CHS-DRG医院智慧运营系统的设计与应用  

Design and Application of CHS-DRG Intelligent Operation System in Hospital

作　　者：刘静[1] Liu Jing(Dongcheng Campus of Anhui Medical University First Affiliated Hospital,Hefei Anhui,231600,China)

机构地区：[1]安徽医科大学第一附属医院东城院区,安徽合肥231600

出　　处：《安徽冶金科技职业学院学报》2024年第3期18-19,22,共3页Journal of Anhui Vocational College of Metallurgy and Technology

基　　金：安徽医科大学第一附属医院东城院区《DRGs付费执行中费用构成分析与医疗质控协同性研究》(课题编号:(院级)2022008)。

摘　　要：为实现医保DRG支付结算全流程智慧化管理与控制,设计一套基于CHS-DRG的医院DRG智慧运营系统。该系统采用B/S架构,通过应用DWH技术、OLAP技术、BI报表技术、DM及可视化等技术进行设计,主要由数据治理、在院监测、运营分析、结算管理和病案质控五大功能模块组成。通过该系统的应用实现了住院患者的入组模拟,点数及费用测算,实现各科室在DRG结算事前、事中、事后全流程控制和管理,病组数、超支结余、次均费用、平均住院日、药占比等各项指标得到有效改善。In order to realize the intelligent management of the whole process of medical insurance payment and settlement of the National Medical Insurance Disease Diagnosis Related Group(CHS-DRG),a hospital DRG intelligent operation system based on CHS-DRG is designed.The system adopts browser/server(B/S)architecture,and is designed by using DWH technology,OLAP technology,BI report technology and DM technology.It is mainly composed of five functional modules:data governance,in-hospital monitoring,operation analysis,settlement management and medical record quality control.Through the application of the system,the group simulation,point number and cost calculation of inpatients are realized,and the whole process control and management of DRG settlement in each department before,during and after DRG settlement are realized.The number of disease groups,overexpenditure balance,average cost per time,average hospitalization days,drug proportion and other indicators have been effectively improved.

关 键 词：疾病诊断相关分组 医院智慧运营 DRG费用管理 

分 类 号：R197.324[医药卫生—卫生事业管理] TP311.52[医药卫生—公共卫生与预防医学]