基于DRG的急性心肌梗死患者分组效果评价与费用分析

Evaluation of Grouping Effect and Cost Analysis of Patients with Acute Myocardial Infarction Based on DRG

目的:评价急性心肌梗死患者DRG分组效果,分析费用异常的原因。方法:采用变异系数和方差减少量评价DRG分组效果,利用结构变动值、结构变动度和结构变动度贡献率分析DRG病组的费用结构,利用无序多分类logistic回归分析影响费用异常类型的因素。结果:急性心肌梗死患者的DRG分组效果良好;影响费用异常类型的因素是抢救、转科、高药占比、高耗占比、住院时间倍率、其他诊断个数、手术个数。结论:DRG在广东地区适用性较好,部分DRG病组的费用结构有待优化;应加强DRG绩效考核,调整卫生资源的配置和使用,从而减轻患者疾病经济负担。

Objective To evaluate the effect of DRG grouping in patients with acute myocardial infarction and analyze the causes of abnormal cost.Methods The effect of DRG grouping was evaluated by coefficient of variation and variance reduction,the cost structure of DRG disease group was analyzed by structural change value,structural change degree and contribution rate of structural change degree,and the factors influencing the types of abnormal cost were analyzed by disordered multi-classification logistic regression.Results The effect of DRG grouping in patients with acute myocardial infarction was good,and the factors influencing the type of abnormal cost were rescue,transfer,high proportion of drugs,high proportion of consumption,multiple rate of hospital stay,the number of other diagnoses and the number of operations.Conclusion The applicability of DRG in Guangdong area is good,and the cost structure of some DRG disease groups needs to be optimized,and the performance evaluation of DRG should be strengthened and the allocation and use of health resources should be adjusted.