神经内科启用全国按疾病诊断相关分组收付费新规的用药分析

Medication Analysis on Application of New Pricing and Payment Regulation on Chinese Diagnosis Related Groups(C-DRG)in Neurology Department

目的临床药师结合医院预启用收付费新规的盈亏预测算情况,了解目前导致专科用药费用增高的影响因素,为后期合理控费提供参考。方法选取2019年1月至2019年3月深圳市第二人民医院病案统计室公布的预测算病例数据,选定神经内科预测算亏损金额最高按疾病诊断相关分组(C-DRG)病例为目标,应用SPSS 18.0统计软件,找出药品花费较高的相关性因素,分析原因并提出合理性建议。结果急诊入院与外院转入的患者可导致更高药品花费。住院时间延长以及合并糖尿病者也是造成药品费用增加的相关因素。结论急诊入院、院外转入、合并糖尿病等是增加药品费用的危险因素,通过病例回顾性研究可为临床提供控费优化建议,经验值得推广。

Objective According to profit and loss prediction of a hospital applying new pricing and payment regulation in advance,clinical pharmacists could find out factors that lead to increase in the costs of special drugs at present,so as to provide reference for reasonable cost control in a later period.Methods Predicted case data published by medical record statistics department of Shenzhen Second People’s Hospital from January 2019 to March 2019 were selected,and Chinese Diagnosis Related Groups(C-DRG)cases with the highest predicted loss in the department of neurology were selected.SPSS 18.0 software was applied to find out the correlation factors of higher drug costs,so as to analyze reasons and put forward reasonable suggestions.Results Patients admitted in our hospital through emergency visits and transferred to our hospital might result in higher drug costs.Longer hospital stays and people with diabetes were also associated with higher drug costs.Conclusion Admission through emergency visits,out-of-hospital transfer,and complicated with diabetes mellitus are risk factors of increasing drug costs.Retrospective study on cases can provide optimization suggestions for clinical cost control,and this experience is worth promoting.