按病种付费制度下武汉市某医院单病种成本效益分析

Cost-benefit Analysis of Single Disease in a Hospital in Wuhan under the Diagnostic Related Groupings

目的:对纳入单病种付费制度的甲状腺肿瘤并行双侧甲状腺全切术病种的住院费用进行成本费用分析并提出相应建议。方法:搜集武汉市某医院甲乳外科2016-2018年病案首页出院主诊断为“甲状腺肿瘤”,主手术操作为“双侧甲状腺全部切除术”的患者相关数据,对此病种住院费用的影响因素进行回归分析,并测算病种成本和损益。结果:病种成本高于病种支付标准,按物价定额支付损益率为-23.89%,费用结构不合理。结论:医院要适应单病种付费管理,必须规范临床路径,改变不合理的费用结构,建立科学合理的指标考核体系,从而降低单病种成本,提高效率。

Objective: To analyze the cost of hospitalization for thyroid tumors with bilateral thyroidectomy included in the single-patient payment system and propose corresponding recommendations. Methods: Relevant data of patients whose principal diagnosis was "thyroid tumor" and whose principle operation was "total bilateral thyroidectomy" in the first page of the medical records of the department of breast surgery of a hospital in Wuhan from 2016 to 2018 were collected.The influencing factors of the disease’ s hospitalization expenses were analyzed by using regression analysis. The profit and loss of disease were measured also. Results: The cost of the disease was higher than the standard payment of the disease. The profit and loss rate were fixed at a price of-23.89%. The cost structure was unreasonable. Conclusion: To adapt the management of single disease payment, hospitals must standardize the clinical pathway, change the unreasonable cost structure, and establish a scientific and reasonable indicator evaluation system, so as to reduce the cost of single disease and improve the efficiency.