基于EMR临床路径在单病种中的应用系统设计与实现

Design and Implementation of Clinical Pathway in DRGs Application System Based on EMR

为破解老百姓看病贵问题,湖北省公立医院收费方式迎来重大变革——改按项目收费为按病种收费.湖北省物价局、省卫计委、省人社厅联合发出通知,决定从2017年12月31日起,在全省213家二级以上城市公立医院,启动按病种收费改革,这也意味着多家湖北省知名的三甲医院,将实现首批101个病种收费同价.按病种付费实际就是规范临床治疗某种特定病种的过程,医院只能向患者收取范围内的标准费用;医院在治疗中如果花费超过该病种标准,超出部分医院自行承担;如果没有达到这个标准,节余部分归医院所有,可以主要用于临床医务工作者的考核.医院从自身效益角度考虑,会在确保治好病的基础上尽量降低成本支出.单病种付费从诊断到治疗,贯穿全过程,涵盖检验、检查、药品使用等.在按病种收费政策下,医院会降低药占比、耗占比,以往的大检查、大处方、超额使用耗材等行为会大幅减少.按病种付费在确保医疗效果的前提下,必将会大大减轻患者的费用负担,大幅改善医患关系.

In order to solve the problem of expensive public health care, the public hospitals in Hubei Province ushered in a major change in the way they charge their doctors. The Provincial Price Bureau, Provincial Health Planning Commission, and Provincial Department of Humanities and Social Council jointly issued a circular and decided that from December 31, 2017 onward, 213 public hospitals in cities above the second-level in the province will be started to start treatment according to disease types. The reform of fees and charges also means that the well-known top hospitals in Hubei Province, will realize the first batch of 101 kinds of diseases with the same price. According to the actual payment of the disease is to regulate clinical treatment of a particular disease process,the hospital can only be charged to patients within the scope of the standard costs, hospitals in the treatment if the cost exceeds the standard of the disease, beyond the part of the hospital itself, if not this standard, the savings part of the hospital owned, can be mainly used for examination of clinical medical workers. Hospital from the perspective of their own effectiveness, will naturally find ways to ensure that good disease on the basis of minimizing the cost of expenditure. DRGs from diagnosis to treatment throughout the entire process, covering inspection, inspection, drug use. Under the fee-for-illness policy, the hospital will reduce the proportion of drugs, the proportion of consumption, the past, major inspections, over-prescription, excessive use of consumables and other acts will be substantially reduced. It can be expected that paying for different kinds of diseases will surely reduce the burden of patients' costs and ensure that the relationship between doctors and patients will also be greatly improved under the premise of ensuring the medical effects.