DRG支付改革下某公立医院干预措施及实施效果分析

Analysis of interventions and implementation effects in public hospitals under DRG payment reform

目的:对DRG支付改革下公立医院采取“双对接,全覆盖”干预措施及实施效果进行分析评价,评估医院现阶段发展成效,以更好地促进医院在“十四五”期间更高质量发展。方法:使用t检验、非参数检验等对干预前后相关指标进行统计分析。结果:第二季度与第一季度相比,DRG相关指标和国考部分指标发生了改变,其中住院总费用、药品费用、药占比、耗材费用、耗占比、次均费用、高倍率病例数、高倍率病例占比差异具有统计学意义;实施干预后,第三季度与第一季度相比,平均基准点数、药品费用、药占比、耗材费用、耗占比、次均费用、高倍率病例数、高倍率病例占比、微创手术例数、微创手术占比差异具有统计学意义;第二季度与第三季度相比,平均住院日、平均基准点数、住院总费用、药占比、耗材费用差异具有统计学意义。结论:“双对接,全覆盖”干预模式有利于提升医院服务能力、降低医疗费用、改善医院监测指标和医院部分国考指标。

Objective:To analyze and evaluate the"double docking,full coverage"intervention measures adopted by public hospitals under the DRG payment reform and their implementation effects,and evaluate the current development effects of hospitals,so as to better promote the high-quality development of hospitals on the new journey of the"14th Five-Year Plan".Methods:T-tests and non-parametric tests were used to analyze the relevant indicators before and after the intervention.Results:Compared with the first quarter,the DRGrelated indicators and some indicators of the national examination changed in the second quarter,among which the total hospitalization cost,drug cost,drug proportion,consumables cost,consumption proportion,the average cost per time,number of high-rate cases,and proportion of high-rate cases were statistically significant.After the intervention,compared with the first quarter,there were statistically significant differences in the average base points,drug cost,drug proportion,consumables cost,consumption proportion,the average cost per time,number of high-rate cases,proportion of high-rate cases,cases of minimally invasive surgery and proportion of minimally invasive surgery in the third quarter.In addition,there were statistically significant differences in the average length of stay,average base points,total hospitalization expenses,drug proportion,and consumable expenses between the second quarter and the third quarter.Conclusion:The"double docking,full coverage"intervention model is beneficial to improve hospital service capacity,reduce medical costs,and improve hospital monitoring indicators and some indicators of hospital national examination.