基于结构变动度的脑梗死按病种付费患者住院费用分析

Analysis of hospitalization expenses of patient with cerebral infarction DRGs based on structural variability

[目的]通过对安徽省某县级医院脑梗死按病种付费患者住院费用的结构变动度分析,为控制医疗费用不合理增长,优化调整医疗费用结构提供对策建议。[方法]收集安徽省某县级医院2016-2019年按病种付费住院信息,以脑梗死患者住院数据为例,采用结构变动度、结构变动值和结构变动贡献率等进行分析。[结果]该院脑梗死患者药品费、化验费占比较大,同时药品费、化验费及检查费各年构成比变动均对住院次均费用产生较高影响,治疗费构成比逐年上升。[结论]按病种付费需进一步提升优化,以体现医务人员劳务价值的费用结构,需对药品费及检查化验费等费用加强监督控制,改革完善突破按病种付费"瓶颈期",实现费用控制等作用最大化。

Objective To provide countermeasures and suggestions for controlling unreasonable increase of medical expenses,optimizing and adjusting the structure of medical expenses through analyzing the structural variation of hospitalization expenses of patients with cerebral infarction DRGs.Methods Hospitalization data of DRGs from 2016 to 2019 in a county hospital of Anhui Province was collected.It took the hospitalization data of cerebral infarction patients as an example,used value of structure variation,degree of structure variation and contribution rate of structure variation to analyze.Results The proportion of drug and test fee for cerebral infarction patients was higher,and the change of constituent ratio in each year on drug,test and examination fee had higher effect on per average hospitalization cost,the proportion of treatment cost rose year by year.Conclusions It is necessary to further improve and optimize for the DRGs,so as to reflect cost structure of labor value of medical personnel,strengthen the supervision and control of drug and inspection fee,reform and break through the"bottleneck period"of DRGs,and realize the maximization of cost control.