基于DRG的综合管理措施对阑尾炎手术患者控费作用效果评价

Effect Evaluation on Cost Control of Operative Appendicitis Patients under DRG-Based Comprehensive Management

目的:通过对样本医院阑尾炎手术患者实施基于DRG的综合管理,探讨降低病种费用,提高诊疗质量与效率,让患者受益的有效方法。方法:剔除北京医改影响因素,通过对费用结构的不合理项目进行原因分析后,有针对性地优化临床路径、改革绩效分配、信息化技术辅助等综合管理措施,对比分析干预前后的管理效果。结果:干预后费用有所下降,床位使用率提升,病历质量管理未下降。结论:DRG背景下的病种管控是综合监管过程,复合型管理措施是有效的;以临床路径为主的综合管控举措在一定程度上可以提高医院管理效能,规范医师诊疗行为,优化医院资源配置。

Objective: To explore the effective methods to reduce the cost of diseases,improve the quality and efficiency of diagnosis and treatment,and benefit patients through the implementation of DRG-based comprehensive management. Methods: After eliminating the influencing factors of health care reform in Beijing,after analyzing the causes of unreasonable items in the cost structure,comprehensive management measures such as optimizing clinical pathway,reforming performance distribution and information technology assistance were managed to compare and analyze the management effects before and after the intervention. Results: After the intervention,the cost was decreased,the bed utilization rate was increased,and the quality management of medical records did not decline. Conclusion: The management and control under the background of DRGs is a comprehensive supervision process,and the compound management measures are effective;the comprehensive management and control measures based on clinical pathway could improve the hospital management efficiency,standardize doctors’ diagnosis and treatment behavior,and optimize the allocation of hospital resources to a certain extent.