疾病诊断相关组在医院临床用血管理中的应用

Application of DRGs in clinical blood management

目的探索疾病诊断相关组(DRGs)指标体系在医院临床用血管理上的应用。方法统计某医院2017~2019年出院患者临床用血信息以及DRGs相关指标,包括病例组合指数(CMI)、DRG分组及相应权重等,比较CMI调整之后的出院患者人均红细胞使用量,确定各年度用血病例数较多的DRGs组,提出具体的临床用血管理方法。结果 2017~2019年本院用血人次数和出院人数始终处于增长状态,而总用血量、CMI调整出院患者人均红细胞使用量呈逐年递减趋势。2017~2019年全院用血病例数居前5位的DRGs共6个,2019年用血病例数前5位DRGs占当年全部DRGs的0.79%(5/629),而前5位的DRGs用血病例数为1 611个,占当年全部用血病例数的37.49%(1 611/4 297)。结论运用DRGs指标体系分析评估近年医院临床用血情况及用血特点,为提高临床用血的合理性,加强医院临床用血管理提供新思路。

Objective To explore the application of the indicator system of disease diagnosis related groups(DRGs) on the management of clinical blood use in hospitals. Methods Statistics information on clinical blood use as well as DRGs indexes including case mixed index(CMI), DRG grouping and corresponding weights among patients discharged during 2017 to 2019 from a hospital were recorded. RBC usage per 100 discharged patients after CMI adjustment and DRGs with a larger number of annual blood use cases were compared to make recommendations on the management of clinical blood use in the hospital. Results From 2017 to 2019, the number of blood users and patients discharged from our hospital kept growing, while the total blood use, RBC usage per 100 discharged patients after CMI adjustment showed a decreasing trend. There were 6 DRGs with the top five blood users from 2017 to 2019, and the top five DRGs accounted for 0.79%(5/629)in 2019, involving 1 611 blood use cases, accounted for 37.49%(1 611/4 297)of all cases of blood use in the year. Conclusion The application of the indicator system of DRGs to evaluate the clinical use of blood in hospitals is conductive to improve the rationality of clinical blood use, and can provide recommendations for the management of clinical blood use.