基于DRG的冠状动脉粥样硬化患者分组效果及住院费用分析

Analysis of Grouping Effect and Hospitalization Cost of Patients with Coronary Atherosclerosis Based on DRG

目的 分析冠状动脉粥样硬化患者疾病诊断相关分组(DRG)分组效果、住院费用结构和内部影响因素,为优化DRG支付方式改革的实施提供参考。方法 收集某三甲综合医院冠状动脉粥样硬化住院患者信息,采用变异系数和整体方差减少系数评价DRG分组效果,采用结构变动值、结构变动度评价DRG病组间住院费用结构变化的特征,通过灰色关联模型分析住院费用内部因素的关联程度。结果 病案首页质量影响DRG入组,冠状动脉粥样硬化DRG分组效果不佳,费用结构不合理。住院患者的费用结构中,耗材费与住院费用的关联程度最大(0.817),其次是药品费(0.665)。结论 应增强临床科室与职能科室的沟通合作,提升病案首页质量;优化冠状动脉粥样硬化DRG费用结构,充分体现医务人员的劳动和技术价值;重视住院费用的主要内部影响因素,采取针对性措施,促进相关费用的控制。

Objective To analyze the grouping effect,hospitalization cost structure and internal influencing factors of DRG in patients with coronary atherosclerosis, so as to provide references for optimizing the reform and implementation of DRG payment mode. Methods The information of hospitalized patients with coronary atherosclerosis in a third-class general hospital was collected. The grouping effect of DRG was evaluated by coefficient of variation and overall variance reduction coefficient. The structural change value and structural change degree were used to evaluate the characteristics of the structural change of hospitalization expenses in DRG disease group. The correlation degree of internal factors of hospitalization expenses was analyzed by grey correlation model. Results The quality of the first page of medical records affected the inclusion of DRG. The grouping effect of coronary atherosclerosis DRG was insufficient,and the cost structure was unreasonable. In the cost structure of inpatients,the correlation between consumables and hospitalization cost was the highest(0.817),followed by drug cost(0.665). Conclusion The communication and cooperation between clinical departments and functional departments should be strengthened to improve the quality of the first page of medical records;optimize the DRG grouping cost structure of coronary atherosclerosis,and fully reflect the labor and technical value of medical staff;pay attention to the main internal influencing factors of hospitalization expenses,and take targeted measures to promote the control of relevant expenses.