按DRGs制定剖宫产患者住院费用标准的研究

Research on Diagnosis Related Groups in Determining In-patient Expenditure Standards for Cesarean Section Patients

目的:对病例组合分类结果是否合理进行评价,为建立以病例组合为基础的住院费用的研究提供方法上的参考。方法:以澳大利亚细化诊断相关组(AR—DRGs)5.0版为基础,采用病例组合-DRG方法,对剖宫产进行类似DRG分组,根据合并症情况分为3组:严重合并症组、中度合并症组、轻或无合并症组,计算各组的标准费用。结果:提取出影响费用的主要因素:住院天数、治疗结果、有无并发症或伴随症、病种类型、年龄、术前天数3组费用及住院时间差异有显著意义。结论:分类变量宜选择与疾病严重程度有关的变量,经组合后取得的住院费用更为切合实际。

Objective： Evaluating the rationality of classifying patients by diagnosis related groups （DRGs）, to provide reference for the research of in-patient expenses based on DRGs. Methods： On the basis of Australian refined DRGs （AR-DRG, version5.0）, the cesarean section patients were divided into 3 groups according to the severity of complications： the group with serious complication, the group with moderate complication, and the group with minor or non complication, and the standard expenses of each group were calculated. Results： The main factors that infl uenced expenses, such as hospitalization days, treatment results, complications or concomitant disorders, disease category, age, days before surgery, were determined. Statistical analysis showed a significant difference between the 3 groups in costs and length of hospitalization stay. Conclusion： The grouping variables should be those related to the severity of disease, the in-patient expenses calculated by DGRs are more feasible.