基于变异系数探索DIP病种同质化管理路径  

Exploring the Path of Homogeneous Management for DIP Disease Based on the Coefficient of Variation

作　　者：王晨 林功晟 马慧芬 陶晓华[1] 周雅俊 WANG Chen;LIN Gongsheng;MA Huifen(The Seventh People's Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai,200137,China;不详)

机构地区：[1]上海中医药大学附属第七人民医院,上海200137

出　　处：《中国卫生质量管理》2024年第11期39-42,共4页Chinese Health Quality Management

基　　金：上海市中西医结合学会管理专业委员会医院管理研究项目(编号:2023-YYGL05);上海中医药大学预算内项目(编号:2021WK115);上海中医药大学附属第七人民医院人才培养计划(编号:XX2023-16)。

摘　　要：目的基于变异系数(CV)分析同质化程度较低的DIP病种,探索管理路径。方法对某三甲医院26894例病种417个DIP病种组计算费用和时间CV,结合病种难度分布和标化费用合理区间进行费用同质化相关性分析,识别重点病种和关键问题,提出DIP病种同质化管理思路。结果DIP病种同质化程度不同,时间和费用同质化程度均较低的病种(CV≥0.6)占26.34%,费用CV≥0.6的病种更易出现异常费用情况且分布在高难度病例;时间和费用CV均≥1的病种占总例数的3.60%,主要为肿瘤或急危重症等住院日长的病种,此类病种为重点问题病种,需进行同质化管理。结论DIP病种存在部分同质化程度低的组别,医疗机构应监测各病种费用和时间CV值,重点管控CV≥1的病种,针对性建立同质化管理路径,实现DIP病种精细化管理。Objective To analyze the DIP diseases with low degree of homogeneity based on coefficient of variation(CV),and to explore the management path.Methods The cost and time CV of 417 DIP groups of 26894 diseases in a tertiary hospital were calculated.Combined with the difficulty distribution of diseases and the reasonable interval of standardized cost,the correlation of cost homogenization was compared and analyzed.The key diseases and key problems were identified,and the idea of DIP diseases homogeneous management was put forward.Results The degree of homogenization of DIP diseases was different.The diseases with low degree of homogenization of time and cost(CV≥0.6)accounted for 26.34%.The diseases with cost CV≥0.6 were more likely to have abnormal costs and were distributed in high-difficulty cases.The diseases with time and cost CV≥1 accounted for 3.60%of the total cases,mainly for the diseases with long hospitalization days such as tumors or acute and critical diseases.These diseases are the key problem diseases and need to be homogenized.Conclusion There are some groups with low degree of homogeneity in DIP diseases.Medical institutions should monitor the cost and time CV value of each disease,focus on controlling diseases with CV≥1,and establish a homogeneous management path to achieve refined management of DIP diseases.

关 键 词：按病种分值付费(DIP) 变异系数(CV) 同质化诊疗 病种管理 

分 类 号：R197.3[医药卫生—卫生事业管理]