DRG付费改革对广西某三甲医院患者住院费用影响研究

Research on the changes in patients’hospitalization expenses after the DRG payment reform in a GradeⅢLevel A hospital in Guangxi

目的:分析广西实施DRG付费改革对住院患者医疗费用的影响。方法:采用描述性分析、卡方检验、Welch’s ANOVA检验、多元线性回归和结构变动度分析等方法,对样本医院在DRG付费改革前后的费用等指标进行统计分析。结果:在实施DRG付费改革后,患者住院费用显著下降(P<0.05),住院费用结构发生改变,药品费占比降低,材料费和治疗费用占比增高;手术和操作治疗患者占比增高,高权重病例占比增高。结论:DRG付费改革能够促进医院控制医疗成本、降低医疗费用、优化费用结构,需要完善配套政策,进一步提升改革成效。

Objective:To analyze the impact of DRG payment reform on the expenses of hospitalization in Guangxi.Methods:Using the descriptive analysis method,chi-square test,Welch’s ANOVA test,multiple linear regression,and structure variation analysis methods to analyze the changes in expenses after the reform.Results:After the reform,the patients’hospitalization expenses showed a downward trend(P<0.05),the composition of hospitalization expenses changed,and the proportion of drug fees was reduced,and the proportion of treatment and medical supplies fee had been increased.The proportion of patients with surgery and operation treatment was increased.The proportion of high-weight cases was increased.Conclusion:DRG payment reform could promote hospitals’cost control,reduce medical expenses,and optimize the composition of hospitalization,but should be perfect in supporting policies to enhance effectiveness.