基于DRGs数据的中医医院住院医疗服务收入占比影响因素分析

Analysis of Influencing Factors on the Proportion of Inpatient Medical Service Income of Traditional Chinese Medicine Hospitals Based on DRGs Data

目的:研究影响住院病例医疗服务收入占比达标率的因素。方法:选取2021年1月-6月在某医院住院的患者病历,以全市同类医院DRG组平均水平作为目标值,通过logistic回归分析内外科住院病例医疗服务收入占比达标的影响因素。结果:外科病例医疗服务收入占比达标率为33.56%,内科病例达标率为31.92%。影响达标率的因素有年龄、住院天数、DRG权重、耗材费用达标情况、医技费用达标情况、药品费用达标情况、是否手术/介入、中医非药物治疗费、手术介入费。外科科室控制耗材费用(OR:6.97(5.18,9.38),P<0.01)、内科科室控制医技费用(OR:5.29(4.36,6.42),P<0.01)将有助于病例医疗服务收入占比达标。结论:外科科室应加强耗材使用管理,管控成本;内科科室应规范检查检验行为,降低例均费用。作为中医医院,应发挥中医药特色优势,鼓励开展中医非药物治疗。基于DRG的标杆比较法具有一定客观性和可推广性。

Objective:To study the factors influencing the proportion of inpatientmedical service incomemeeting the standard rate.Methods:Select patients who were hospitalized in acertainhospital from January to June 2021,and use the average level of the DRG group in similar hospitals in the city as the target value,and analyze by logistic regressionto analyze the influencing factors of the proportion of medical service income of medical and surgical inpatient cases reaching the standard.Results:The compliance rate of surgical casemedical service revenuewas 33.56%,and the compliance rate of medical cases was 31.92%.The influencing factors are age,number of days in hospital,DRG weight,consumables cost compliance,medical technology costcompliance,drug costcompliance,surgery/intervention,TCM non-drug treatment cost,and surgical intervention cost.Surgical department control of consumables costs will help meet the standard(OR:6.97(5.18,9.38),P<0.01).Medicine department control of medical technology costwill help meet the standard(OR:5.29(4.36,6.42),P<0.01).Conclusion:The surgical department should strengthen the management of the use of consumables and control the cost.The internal medicine department should standardize the inspection and inspection behavior and reduce the average cost of each case.As a traditional Chinese medicine hospital,it should give full play to the advantages of TCM and encourage the development of non-drug treatment of TCM.The benchmark comparison method based on DRG has a certain degree of objectivity and generalizability.