2016年骨科医保按病种分组付费(DRGs)亏损病种分组统计分析

Statistical Analysis of Expense Loss Groups in the Department of Orthopedics based on(DRGs) in 2016

目的分析2014年-2016年北京市某三甲医院骨科按病种分组付费亏损病种分组的费用情况,探讨住院费用控制对策。方法对某医院2014年-2016年骨科按病种分组付费亏损病种分组病例进行人次及费用统计分析。使用描述统计法,用Excel表格形式汇总全部病例费用信息,通过病例数量的变化、亏损费用的逐年变动、费用结构中异常变化项目,作为分析亏损原因的数据支持。结果 2014年-2016年骨科亏损病例数大幅增加由146份上升至260份,例均亏损幅度加大,2016年例均亏损14 733元,同时三年间平均耗材占比由71%上涨到84%。结论骨科收治病种发生变化,因耗材使用量逐年增加导致医疗费用上涨。

Objective To analyze the cost of DRGs in a department of orthopedics of a three grade hospital in Beijing during 2014 and 2016, and to discuss the cost control measures. Methods A case study was conducted in a department of orthopedics from 2014 to 2016. The number of cases and the expenses were analyzed statistically.Descriptive statistics method is used to collect all case cost information in Excel form. Through the change of the number of cases, the annual change of the loss expense, the abnormal changes in the cost structure, as the data support for the analysis of the cause of the loss. Results The number of deficit cases in Department of orthopedics increased from 146 to 260 copies from2014 to 2016. The average loss was increased. 2016 years of losses were 14733 yuan. At the same time, the average consumables ratio increased from 71% to 84% in three years.Conclusion The diseases in Department of orthopedics were changed, and the consumption of consumables increased year by year, leading to the rise of medical expenses.