基于疾病诊断相关分组的脑梗死住院费用影响因素分析

Influencing factors of hospitalization cost of cerebral infarction based on DRG grouping

目的探讨脑梗死疾病诊断相关分组(DRG)的住院费用影响因素。方法回顾性分析2018年在江门市某三级公立医院住院治疗的2434例脑梗死患者DRG组内和组间差异评价,组内采用变异系数(CV)进行评价,组间采用秩和检验,住院费用的影响因素采用多元线性回归分析。结果脑梗死患者主要分布在BR21、BR23和BR25三个DRG组,BR23与BR25分组结果较好,BR21分组结果一般,三组之间的住院费用的差异具有统计学意义,影响BR21组住院费用的影响因素为住院天数和离院方式,影响BR23组住院费用的影响因素为住院天数和抢救次数,影响BR25组住院费用的影响因素为性别、抢救次数和住院天数。结论DRG分组需分析其变异系数,根据当地实际情况进行调整并重新细化分组,建立精细化的脑梗死DRG控费工具,减少住院费用,降低患者的经济负担。

【Objective】To explore the influencing factors of hospitalization costs in the DRG group of cerebral infarction.【Methods】DRG subgroup and intragroup differences in 2434 patients with cerebral infarction treated in a tertiary public hospital in Jiangmen City in 2018 were retrospectively analyzed,coefficient of variation(CV)was used for evaluation within the group,rank sum test was used between the groups,and multivariate linear regression analysis was used for influencing factors of hospital expenses.【Results】Cerebral infarction patients were mainly distributed in three DRG groups:BR21,BR23 and BR25;BR23 and BR25 grouping results were better,BR21 grouping results were average;the difference in hospitalization costs between the three groups was statistically significant.The factors influencing the hospitalization costs of the BR21 group were the number of hospitalization days and the way to leave the hospital.The factors influencing the hospitalization costs of the BR23 group were the number of hospitalization days and the number of rescues.The factors influencing the hospitalization costs of the BR25 group were gender,the number of hospitalization days and the number of rescues.【Conclusion】The CV of DRG needs to be analyzed and adjusted according to local actual conditions,refined grouping is needed to establish a refined DRG cost control tool for cerebral infarction,in order to reduce hospitalization costs and the financial burden on patients.