美国AP-DRGs对我国建立DRGs模型的启示

Enlightenment of AP-DRGs in USA to the Establishment of DRGs Model in Our Country

通过分析美国AP-DRGs对几个常见分组问题的解决方案,为建立更合理的DRGs分组模型提供研究思路。分析后认为,对于局部肿瘤和先天性疾病的归类,应根据疾病的实际发生部位把病例归入现有的25个主要诊断分类中,建立分组时应根据疾病或手术的特点采用合适的疾病或手术划分方法与并发症判断标准,DRGs分组的数量应限制在1500个以下。总之,可通过借鉴国外的DRGs模型,分析我国现有DRGs模型的问题,并找出解决问题的办法,从而开发出更合理有效的DRGs分组模型。

Through analyzing the solutions of several common questions on grouping in the AP-DRGs of USA, to provide research approach for the establishment of grouping models which suit for the national situation of China. After theanalysis, we found that if the DRGs model in our nation wants to conduct classification to the local tumor, congenital diseases and the disease cases in different practical positions, we should make classification of them into the 25 principal diagnosis according to different anatomy systems. And also we should Conduct the classification according to the serious degree of the diseases or the complicated degree of operations, adopt different judgment standards of complications on the basis of different situations or different first diagnosis, and the quantitative limitation of DRGs grouping would better no more than 1500. Through a summary on the problems existing in the models available, we could find out relatively solutions and develop a DRGs grouping system which suit for our national situation with the reference of advantages in the foreign grouping models.