基于DRGs的新生儿产伤发生率调整研究

Risk-adjusting Effect of DRGs on Birth Trauma Rate

目的对新生儿产伤情况及影响因素进行调查,评价WI-DRGs对新生儿产伤风险模型的调整效果,探讨WI-DRGs对质量指标评估的作用。方法对3所医疗机构2011—2016年新生儿产伤率及影响因素进行分析,并建立DRGs调整的新生儿产伤logistic回归模型,评估WI-DRGs对新生儿产伤率的调整效果。结果新生儿产伤发生率为0.852/‰,对新生儿产伤有统计意义的影响因素为新生儿出生体重、产妇合并症与并发症、WI-DRGs分组等。应用logistic模型估计期望新生儿产伤数,计算甲、乙、丙医院新生儿产伤比(实际/期望)分别为1.082、1.050、0.839。结论 WI-DRGs是有效的质量指标调整工具,今后应在新生儿产伤率的研究基础上,利用DRGs结合NLP、QDM等信息应用技术,开发并建立适合我国妇幼专科的信息化综合质量评估平台。

Objective To evaluate the adjusting effects of WI-DRGs on the birth trauma of newborns, and explore the effect of WI-DRGs on quality evaluation. Methods Birth traumas data from 3 hospitals from 2011 to 2016 were analyzed by univariate analysis and logistic regression to evaluate the effects of WI-DRGs and other factors. Results The overall birth trauma rate of newborn is 0.852/1000. The univarate analysis shows that birth weight, puerpera’s complication and comforbidity, and WI-DRGs have the statistical significant effects on the birth trauma of newborn. The expected counts of birth trauma of newborn are calculated by logistic regression, and the ratio of real counts to expected counts are 1.082, 1.050 and 0.839 for 3 hospitals, respectively. Conclusion WI-DRGs is a effective quality evaluating tool. WI-DRGs, integrated with the NLP and QDM technology, can be used to build a comprehensive quality evaluation system for women and children specialty based on its application on birth trauma. Consequently, quality data will be managed and assessed developed and established.