基于病例组合指数与秩和比法的住院患者次均药品费用分档评价模型的建立与应用  

Establishment and application of evaluation model of Inpatient average drug costs based on CMI and rank-sum ratio

作　　者：周庆秋 杜松 冯飞飞 耿晓晓 ZHOU Qingqiu;DU Song;FENG Feifei;GENG Xiaoxiao(Department of Pharmacy,the Affiliated Tai'an City Central Hospital of Qingdao University,Shandong Province,Tai'an 271000,China;Medical Insurance Price Management Department,the Affiliated Tai'an City Central Hospital of Qingdao University,Shandong Province,Tai'an271000,China)

机构地区：[1]青岛大学附属泰安市中心医院药学部,山东泰安271000 [2]青岛大学附属泰安市中心医院医保物价管理科,山东泰安271000

出　　处：《中国当代医药》2024年第34期105-109,共5页China Modern Medicine

摘　　要：目的基于病例组合指数(CMI)调整住院患者次均药品费用,实现分档评价临床科室用药情况。方法选取2022年1月1日至2023年12月31日青岛大学附属泰安市中心医院出院患者的病案首页数据,运用秩和比法(RSR)进行综合评价和水平分档。结果医院各临床学科治疗疾病难度与次均药品费用水平存在差异,39个科室可分为4档,与住院患者次均药品费用单一指标评价比较,15个科室评价结果相同,占比38.46%。需加强管理(下调级别)的科室有15个,占比38.46%。可减少管理成本(上调级别)的科室有9个,占比23.08%。结论在区域点数法总额预算和按病种分值付费(DIP)背景下,基于CMI与RSR的住院患者次均药品费用分档评价模型调整各科室住院患者次均药品费用指标并实行分层评价的方法,可以提升管理效率,有效地对临床科室的住院患者次均药品费用实施管控。Objective To evaluate and realize the medication utilization in clinical departments by adjusting inpatient average drug costs based on the case mix index(CMI).Methods Data was collected from the Affiliated Tai'an City Central Hospital of Qingdao University discharge records from January 1st to December 31st,applied rank sum ratio(RSR)method to rank CMI and inpatient average drug costs for comprehensive evaluation and level classification.Results There were differences in the difficulty of treating diseases and the average drug cost level among different clinical disciplines in the hospital,with 39 departments divided into 4 levels,and compared with the single evaluation of average drug costs for inpatients.A total of 15 departments had identical evaluation results,accounting for 38.46%,15 departments that need to strengthen management(downgrade),accounting for 38.46%.A total of 9 departments that can reduce management costs(upgrade),accounting for 23.08%.Conclusion In the context of Diagnosis-intervention acket(DIP),the grading evaluation model of based on CMI and rank sum ratio method enhances management efficiency,effectively controlling inpatient average drug costs in clinical departments.

关 键 词：住院患者次均药品费用 病例组合指数 秩和比法 分档评价 

分 类 号：R97[医药卫生—药品]