基于病情的DRG相对权重比较与启示

Comparison and enlightenment of relative weight of DRG based on disease condition

目的分析不同病情病例DRG相对权重的差别,探讨提高DRG正确入组的方法,为医院现代化管理提供参考。方法在广东省卫健委统计信息网络直报系统下载2018年广东省三级医院DRG各分组相对权重、某三甲医院的分组结果以及2018年1月1日至12月31日出院的79303例患者病案首页数据。将不同病例分型、是否抢救和不同手术级别的相对权重进行比较。应用F分析和t检验对数据进行统计分析。结果疑难、危重和抢救病例的相对权重高于一般病例。随着手术级别的提高,相对权重呈现上升的趋势。结论相对权重的大小与病例分型及手术评估具有一致性,是反映医疗技术难度的理想指标,医院应通过核查住院病案首页数据的准确性,提高DRG的正确入组率。

Objective To analyze the difference of relative weight of DRG in patients with different diseases,and to explore the method to improve the correct grouping of DRG,so as to provide a reference for modern hospital management.Methods Download the relative weight of each group of DRG in the third level hospital of Guangdong Province in 2018,the group results of a third level hospital and the home page data of 79303 patients discharged from the hospital from 1 January to 31 December,2018 in the statistics network direct report system of Guangdong Health Committee.The relative weights of different cases,rescue or not and different operation levels were compared.The data were analyzed by variance analysis and t-test.Results The relative weight of difficult,critical and rescue cases was higher than that of general cases.With the improvement of operation level,the relative weight is increasing.Conclusion The relative weight is consistent with case classification and surgical evaluation,and it is an ideal index reflecting the difficulty of medical technology.The hospital should check the accuracy of the home page data of inpatient medical records to improve the correct enrollment rate of DRG.