基层妇幼保健院儿童康复科的DRG病组分析  

Analysis of DRG disease group of children rehabilitation department of primary maternal and child health hospital

作　　者：李小玲 刘远波 LI Xiaoling;LIU Yuanbo(Department of Children's Rehabilitation,Maternal and Child Health Hospital of Cenxi,Cenxi 543200,Guangxi,China;Administration Department of Hospital,Maternal and Child Health Hospital of Cenxi,Cenxi 543200,Guangxi,China)

机构地区：[1]广西岑溪市妇幼保健院儿童康复科,广西岑溪543200 [2]广西岑溪市妇幼保健院医院行政科,广西岑溪543200

出　　处：《右江医学》2024年第11期989-994,共6页Chinese Youjiang Medical Journal

基　　金：广西壮族自治区中医药管理局自筹经费科研课题(GXZYD20220540)。

摘　　要：目的探讨在诊断相关分组(DRG)体系下,基层妇幼保健院儿童康复科的DRG病种入组状况及其对科室管理运营的影响。方法选取2023年1月至12月期间,在广西某市妇幼保健院儿童康复科住院并以DRG方式支付结算的病例,对儿童康复病例的DRG病种构成、权重以及医保费用等数据进行分析,并对比实施DRG结算前后(2021年与2023年)的住院天数、药品费用占比、耗材费用占比等效率指标以及患者满意度。结果2023年共入组2108个病例,其中核心疾病诊断相关分组频次较高的依次为儿童期精神发育障碍(占45.11%)、神经系统变性疾患(占27.61%)、精神心理康复(占8.59%)。全年DRG支付盈亏率为-2.10%,其中以运动障碍为主的神经系统变性疾患组别盈利显著,而以童年孤独症为主的儿童期精神发育障碍组别亏损较多。实施DRG结算前后住院天数无显著变化,药品费用占比与耗材费用占比均有所下降,患者满意度有所提升。结论在DRG体系下,基层妇幼保健院儿童康复科面临一定程度的资源分配不均问题。为应对此挑战,需结合政策导向和社会经济发展状况,进一步优化学科建设,合理配置医疗资源,同时提升治疗效果和经济效益。Objective To explore the enrollment status of diagnosis-related group(DRG)diseases in the children rehabilitation department of primary maternal and child health hospital under the DRG system and its impact on department management and operation.Methods Cases hospitalized to the children rehabilitation department of a maternal and child health hospital in a certain city in Guangxi from January to December 2023 and settled through DRG payment were selected.Data included the composition,weight,and medical insurance costs of DRG diseases in children rehabilitation cases were analyzed,and efficiency indicators such as hospitalization days,drug cost proportion,consumables cost proportion before and after the implementation of DRG settlement(2021 and 2023),as well as patient satisfaction were compared.Results A total of 2108 cases were enrolled in 2023,among which the higher frequency of grouping related to core disease diagnosis was childhood mental development disorders(45.11%),neurological degeneration disorders(27.61%),and psychosocial rehabilitation(8.59%).The profit and loss rate of DRG payment for the whole year was-2.10%,among which the group of neurological disorders mainly with movement disorders made significant profits,while the group of childhood mental development disorders mainly with childhood autism suffered more losses.There was no significant change in hospitalization days before and after the implementation of DRG settlement.The proportion of drug expenses and consumables expenses decreased,and patient satisfaction increased.Conclusion Under the DRG system,the children rehabilitation department of primary maternal and child health care hospitals faces the problem of uneven resource distribution to a certain extent.In order to meet this challenge,it is necessary to further optimize the discipline construction,rationally allocate medical resources,and improve the treatment effect and economic benefits by combining the policy guidance and social and economic development.

关 键 词：儿童康复 诊断相关分组(DRG) 病种分类 医疗资源配置 

分 类 号：R197.3[医药卫生—卫生事业管理]