DRG付费改革对甲状腺恶性肿瘤手术患者住院费用的影响  

Study on the Impact of DRG Payment Reform on the Hospitalization Cost of Patients with Thyroid Malignant Tumors

作　　者：刘芳[1] 杨子健 LIU Fang;YANG Zijian(Department of Medical Insurance,The First Affiliated Hospital of University of Science and Technology of China,Anhui Provincial Hospital,Hefei,Anhui 230001)

机构地区：[1]中国科学技术大学附属第一医院、安徽省立医院医保处,安徽合肥230001

出　　处：《江苏卫生事业管理》2025年第1期98-102,共5页Jiangsu Health System Management

基　　金：2022年度科大新医学联合基金资助(YD9110002030)。

摘　　要：目的:分析DRG付费改革对甲状腺恶性肿瘤手术患者住院费用和费用结构变动的影响,为医院精细化管理提供参考。方法:采用倾向性评分匹配法(PSM)消除DRG实施前后潜在差异,通过灰色关联分析法和结构变动分析法,对比分析安徽省某三甲医院2019-2020年(DRG付费改革前)与2021-2022年(DRG付费改革后)甲状腺恶性肿瘤手术患者的住院费用和费用结构。结果:DRG实施后,患者平均住院费用从16966.05元降至15780.88元,除手术费用外,其他费用及住院天数均减少,差异均具有统计学意义(P<0.05)。灰色关联度分析显示药品费和诊断费与住院费用关联度最高。结构变动分析表明药品费(30.37%)和医用手术费(44.57%)是费用结构变动的主要因素。结论:DRG付费改革有效降低了甲状腺恶性肿瘤手术患者的住院费用,优化了费用结构,对医院管理具有重要指导意义。Objective:To analyze the impact of the DRG payment reform on the hospitalization costs and cost structure changes of patients undergoing surgery for thyroid malignant tumors,providing a reference for refined hospital management.Methods:Propensity Score Matching(PSM)was utilized to eliminate potential differences before and after the implementation of DRG.Grey relational analysis and structural change analysis were employed to compare the hospitalization costs and cost structures of patients with thyroid malignant tumors who underwent surgery in a tertiary hospital in Anhui Province from 2019-2020(before DRG reform)and 2021-2022(after DRG reform).Results:After the implementation of DRG,the average hospitalization cost per patient decreased significantly from 16966.05 RMB to 15780.88 RMB(P<0.001).Except for surgical costs,all other costs and the length of hospital stays were reduced,with statistical significance(P<0.05).The gray relational analysis indicated that drug costs and diagnostic fees had the highest correlation with hospitalization costs.Structural change analysis revealed that drug costs(30.37%)and medical surgical fees(44.57%)were the main factors causing changes in the cost structure.Conclusion:The DRG payment reform has effectively reduced the hospitalization costs for patients undergoing surgery for thyroid malignant tumors and optimized the cost structure,which is of significant guiding importance for hospital management.

关 键 词：DRG 支付方式改革 甲状腺恶性肿瘤 住院费用 

分 类 号：R197.1[医药卫生—卫生事业管理]