基于DRGs的临床专科结构转型效果评价研究  

Evaluation of Clinical Specialty Structural Transformation Effect Based on DRGs

作　　者：梁艳超[1] 王晓岩[1] Liang Yanchao;Wang Xiaoyan(Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China;不详)

机构地区：[1]首都医科大学附属北京天坛医院,北京市100070

出　　处：《中国病案》2025年第3期11-15,共5页Chinese Medical Record

基　　金：天坛医院科研基金(管理专项)(TYGL202202)。

摘　　要：目的探讨基于DRGs的临床专科结构转型效果,为医院合理规划学科及病种结构提供参考。方法选择2017年1月1日—2022年12月31日北京市某院与市属综合及央属综合等标杆值的MDC及RW分布数据进行回顾性分析,采用卡方检验对医院转型前后的MDC、DRGs结构占比进行纵向对比;同时采用2022年的数据对某院与市属综合、央属综合等标杆值进行横向对比。结果某院DRGs组数由607组增加到640组,增加了33组。新生儿及先期分组实现了零的突破,MDCF-循环系统结构占比由5.5%增加到6.7%,MDCR-骨髓增生及肿瘤放化疗结构占比由5.9%增加到15.7%,MDCB-神经系统结构占比由47.3%降低到38.8%。横向对比,MDCB-神经系统结构占比明显高于市属综合医院(10.9%)及央属综合医院(4.7%),MDCF-循环系统作为常见病多发病结构占比(6.7%)明显低于市属综合医院(15.7%)及央属综合医院(7.2%),MDCR-骨髓增生及肿瘤放化疗结构占比与市属综合医院及央属综合医院基本持平。RW≤0.5的占比由2017年的20.7%增加到22.2%,RW>2.5的占比由21.7%降低到20.8%。结论转型后基础学科患者占比明显增加,学科均衡性有了明显改善,基础学科振兴计划取得初步成效。但与标杆值对比,常见病多发病的收治能力需进一步提高,基本实现了量的增长,仍需进一步加强质的提高。Objectives This study aims to explore the effects of the transformation of clinical specialty structures based on DRGs,providing a reference for hospitals to rationally plan their discipline and disease structures.Methods The MDC and RW distribution data of a hospital in Beijing from January 1,2017 to December 31,2022 were retrospectively analyzed,and the MDC and DRGs structure proportions before and after the hospital transformation were longitudinally compared using the chi-square test.At the same time,the data from 2022 was used to make a horizontal comparison between a certain hospital and the benchmark values of municipal comprehensive hospitals,central comprehensive hospitals,etc.Results The number of DRGs groups in a certain hospital increased from 607 to 640,an increase of 33 groups.The newborn and pre-term grouping achieved a breakthrough.The proportion of MDCF-circulatory system structure increased from 5.5% to 6.7%,the proportion of MDCR-bone marrow hyperplasia and tumor radiotherapy and chemotherapy structure increased from 5.9% to 15.7%,and the proportion of MDCB-nervous system structure decreased from 47.3%to 38.8%.However,in horizontal comparison,the proportion of MDCB-nervous system structure was significantly higher than that of municipal general hospitals(10.9%)and central general hospitals(4.7%),the proportion of MDCF-circulatory system as a common disease structure(6.7%)was significantly lower than that of municipal general hospitals(15.7%)and central general hospitals(7.2%),and the proportion of MDCR-bone marrow hyperplasia and tumor radiotherapy and chemotherapy structure was basically the same as that of municipal general hospitals and central general hospitals.The proportion of RW≤0.5 increased from 20.7% in 2017 to 22.2%,and the proportion of RW>2.5 decreased from 21.7% to 20.8%.Conclusions After the relocation and transformation,the proportion of basic specialty patients increased significantly,the balance of disciplines was significantly improved,and the basic discipline revitalizatio

关 键 词：DRGS 临床专科 病种结构 

分 类 号：R197.3[医药卫生—卫生事业管理]