DRG付费政策对血管外科医保患者住院费用的影响研究

Study on Influence of DRG Payment Policy on Hospitalization Expenses of Vascular Surgery Patients with Medical Insurance

目的分析DRG支付政策对血管外科医保患者住院费用的影响。方法以2020年1月1日—2022年12月31日血管外科核心DRG组中的医保结算病例为研究对象,分为2020年、2021年和2022年三组进行比较。采用方差分析比较组间差异,LSD进行组间两两比较,以p<0.05为差异有统计学意义。结果DRG实施后,血管外科平均住院时间呈下降趋势,部分DRG组的总费用、药费和耗材费也呈下降趋势。FE13、FF33、FF35、FN11、FW13和FW23组的平均住院日显著下降(p<0.05)。FM23和FN23组中,2021年和2022年的总费用低于2020年(p<0.05),FN11组在2022年的总费用也低于2020年(p<0.05),FE13、FF33、FF35、FM23和FN11组在2022年的药费最低,FF33、FM23、FN11和N23组在2021年和2022年的耗材费均低于2020年。结论DRG实施后,血管外科医保患者住院时间缩短,部分DRG组的总费用、药费和耗材费均有所下降,这表明DRG支付政策取得了一定成效。

Objective To analyze the effect of DRG payment policy on hospitalization expenses of vascular surgery patients with medical insurance.Methods The medical insurance settlement cases in the vascular surgery core DRG group from January 1st,2020 to December 31th,2022 were divided into three groups by year for comparison.Anova was used to compare the differences between groups.LSD was used to compare pairwise between groups.p<0.05 was considered statistically significant.Results After the implementation of DRG,the average hospital stay in vascular surgery department showed a decreasing trend,and the total cost,drug cost and consumable cost in some DRG groups also showed a decreasing trend.The mean length of stay in FE13,FF33,FF35,FN11,FW13 and FW23 groups decreased significantly(p<0.05).In the FM23 and FN23 groups,total expenses were lower in 2021 and 2022 than those in 2020(p<0.05).The total cost of the FN11 group in 2022 was also lower than in 2020(p<0.05).FE13,FF33,FF35,FM23 and FN11 groups had the lowest drug costs in 2022,and FF33,FM23,FN11 and N23 groups had lower consumables costs in 2021 and 2022 than those in 2020.Conclusion After the implementation of DRG,the hospital stay of medical insurance patients in vascular surgery department was shortened,and the total cost,drug cost and consumables cost of some DRG groups were reduced,which indicated that the DRG payment policy has achieved some success.