基于DRG病组的临床路径管理实践探索  

Exploration of Clinical Pathway Management Practice based on DRG Disease Group

作　　者：郑晓菊 黄静[1] 廖友鑫 陶洲 曹洁 ZHENG Xiaoju;HUANG Jing;LIAO Youxin;TAO Zhou;CAO Jie(Jiangjin Hospital Affiliated to Chongqing University,Jiangjin Central Hospital of Chongqing,Chongqing 402260,China)

机构地区：[1]重庆大学附属江津医院,重庆市江津区中心医院,重庆402260

出　　处：《卫生经济研究》2024年第12期24-28,共5页

基　　金：重庆市江津区科技计划项目“基于DRG医保支付背景下的公立医院临床路径改革和创新的应用研究”(Y2022012);重庆大学附属江津医院2024年院级培育项目“DRG支付方式下临床路径管理效果的实证研究”(2024LCXM001)。

摘　　要：目的:总结基于DRG病组的临床路径管理实践及成效,为DRG支付下优化临床路径管理提供实证参考。方法:选取样本医院6个常见病种1 997个病例数据,分为传统临床路径组(TCP)和基于DRG病组的临床路径组(CP-DRG),分析两组临床路径管理评价指标、医疗资源消耗指标、医疗资源消耗指标变异系数的差异。结果:与TCP组比较,6个病种CP-DRG组路径完成率升高,变异率和退出率降低,但仅脑梗死的两组差异有统计学意义;CP-DRG组在管控平均住院日、次均住院费用、药占比、耗占比方面的优势突出。结论:在传统临床路径的基础上,结合DRG病组建立的临床路径,在提升路径管理效果、节约医疗资源消耗方面具有一定的优势。Objective To summarize the practice and effectiveness of clinical pathway management based on DRG disease group, and to provide empirical references for optimizing clinical pathway management under DRG payment. Methods 1 997 case data of 6 common diseases in the sample hospital were selected and divided into traditional clinical pathway group(TCP) and clinical pathway group based on DRG disease group(CP-DRG), and the differences in evaluation indexes of clinical pathway management, consumption indexes of medical resources,and coefficients of variation of medical resource consumption indexes were analyzed between the two groups. Results Compared with the TCP group, the pathway completion rate of the CP-DRG group for the six disease groups increased, and the coefficient of variation and dropout rate decreased, but the difference between the two groups was statistically significant only for the path completion rate of cerebral infarction. The CP-DRG group was superior to the TCP group in average hospitalization days, average hospitalization expenses, average drug proportion and average consumption proportion. Conclusion On the basis of traditional clinical pathway, the clinical pathway based on DRG disease group has certain advantages in improving the effect of pathway management and saving medical resource consumption.

关 键 词：临床路径 DRG病组 医疗资源消耗 

分 类 号：R197.3[医药卫生—卫生事业管理]