DRG支付政策对儿童专科诊疗的影响研究  

Study on Impact of DRG Payment Policy on Children's Specialty Care

作　　者：张思宁 沈惠芳 黄明慧 罗志红 胡艺琼 ZHANG Si-ning;SHEN Hui-fang;HUANG Ming-hui;LUO Zhi-hong;HU Yi-qiong(Anhui Provincial Children's Hospital/Anhui Hospital,Children's Hospital of Fudan University)

机构地区：[1]安徽省儿童医院/复旦大学附属儿科医院安徽医院

出　　处：《医院管理论坛》2024年第10期17-20,55,共5页Hospital Management Forum

摘　　要：目的探索DRG支付方式对儿童专科医疗的影响。方法选取安徽省儿童医院2022年1月—6月的9192份出院病历,根据合肥市首次纳入DRG情况和方案,从病组类型、费用构成、专科特点、病组权重等向本院儿童专科医生发放自制问卷。结果65.85%的医生大致了解DRG支付改革,58.54%支持DRG支付改革;12.20%的医生认为DRG对医疗行为影响较大,85.37%认为对患者收治情况不影响,92.68%认为不影响门诊量。9192份病例入组9174份,高、低倍率病例各占2.94%、4.74%。试算DRG支付费用与诊疗实际费用差额约为-600万元。结论DRG支付有助于减轻“看病难、看病贵”问题,但对疑难危重病例、新生儿、早产儿抢救、新技术开展方面,政策亟待优化。Objective To explore the impact of DRG payment on children's specialist medical care.Methods A total of 9192 discharged medical records of Anhui Provincial Children's Hospital from January to June 2022 were selected.A selfadministered questionnaire was distributed to our paediatricians in terms of type of disease group,cost components,specialty characteristics,and weighting of disease groups in accordance with the first DRG inclusion and programme in Hefei.Results 65.85%of the doctors generally understood the DRG payment reform,and 58.54%supported the DRG payment reform.12.20%of the doctors believed that DRG had a great impact on medical behavior,85.37%believed that it had no impact on the treatment of patients,and 92.68%believed that it had no impact on the outpatient amount.A total of 9174 cases of 9192 cases were enrolled,and the high and low multiplicity cases accounted for 2.94%and 4.74%,respectively.The difference between the DRG payment and the actual diagnosis and treatment cost was about-6 million yuan.Conclusion DRG payment can help alleviate the problem of"narrow access to medical service",but the policy needs to be optimized in terms of difficult and critical cases,neonatal and premature infant rescue,and new technology development.

关 键 词：疾病诊断相关组 支付改革 儿童专科 

分 类 号：R197.5[医药卫生—卫生事业管理]