应用病例分型评价医疗费用和住院日

Application of disease-case classification in evaluation on medical cost and hospitalization date

目的探讨以病例分型为基础的质量费用管理方式，用于分析同一病种不同病情的患者所花费的医疗费用和住院日之间的差别。方法对呼吸内科751例和综合内科776例肺部感染患者进行病例分型，分别统计A、B、C、D型的医疗费用和住院日。结果不同分型患者之间医疗费用和住院日都有显著性差异；呼吸内科A、C型医疗费用和C型住院日较综合内科少，差异有统计学意义；综合内科C型率较呼吸内科高，呼吸内科D型率较综合内科高，P〈0．001。结论应用病例分型有助于科学控制和合理评价患者医疗费用高低和住院日长短，也为真实反映不同医疗单位的诊疗质量和效率提供客观的依据。

Objective To discuss how to apply the quality cost management mode that is based on disease-case classification for analyzing the difference of medical cost and hospitalization date between patients who have the same disease but in different condition. Methods Divide patients with lung infection including 751 cases of respiratory department of medicine and 776 cases of integrated department of medicine into A, B, C and D categories; analyze the medical cost and hospital stay length using statistical methods. Results The medical cost and hospital stay length have significant difference between patients with different disease-case classification. The medical cost of respiratory department of medicine from categories A and C as well as the length of hospital stay of category C are less than the integrated department of medicine, which has showed the significant difference in statistics. The rate of the integrated department of medicine category C is higher than the respiratory department of medicine, the rate of the respiratory department of medicine category D is higher than the integrated department of medicine category, and P 〈 0. 001. Conclusion The application of diseasecase classification will benefit to scientifically control and rationally evaluate the patients＇ medical cost and hospital stay length. It will also provide objective evidence for truly reflecting the clinic quality and efficiency of different medical units.