基于DRGs的科室性质对神经系统住院费用的研究

A Study of the Costs of Neurological Hospitalization based on DRGs Department Nature

目的探讨神经系统患者中内科治疗患者住院费用的影响因素,为规范提高资源利用效率提供参考。方法数据来源于2019年9月至12月某医院神经系统中非手术治疗的470例患者的病案首页,利用单因素分析和线性回归分析,探索该部分病例在内科科室和外科科室治疗的住院费用上的差异。结果对于进入神经系统的内科治疗病组病例而言,出院科室为神经内科和神经外科在住院总费用上有显著差异(P<0.05),神经外科出院的患者总费用高于神经内科,差异具有显著效益(P<0.05)。结论对于神经系统疾病内科治疗患者,在相同的疑难程度和疾病转归下,外科科室收治会消耗更多的医疗资源,产生更高的医疗费用,因此,不鼓励外科收治内科病人,建议外科将优质资源服务于有明显手术指征的患者,提高手术患者占比,调整病组结构,实现资源的最大化利用和科室的精细化管理。

Objective:To explore the influencing factors of the hospitalization costs of patients with medical treatment in nervous system,and provide references for standardizing and improving the efficiency of resource utilization.Method:The data were collected from the first page of medical records of 470 patients with non-surgical treatment of nervous system in a hospital from September to December 2019.Univariate analysis and linear regression analysis were used to explore the differences in hospitalization costs between the internal medicine department and the surgical department.Result:For the patients in medical treatment group who entered the nervous system,there was a significant difference in the total hospitalization cost between the department of neurology and the department of neurosurgery(P<0.05).The total hospitalization cost of the patients discharged from the department of neurosurgery was higher than that of the department of neurology(P<0.05),and the difference had significant benefits(P<0.05).Conclusion:For medical treatment of patients with nervous system diseases,under the same degree of difficulty and disease outcome,in the surgical department admitted will consume more medical resources,and produce higher medical costs.Therefore,the surgical department is not encouraged to admit internal patients.And it is suggested that the surgical department should provide high-quality resources to the patients with obvious surgical indications,increase the proportion of surgical patients,adjust the structure of the patient group,and realize the maximum utilization of resources and the refined management of the department.