基于DRGS改革对医保患者住院费用的影响

Influence of DRGS reform on hospitalization expenses of medical insurance patients

目的 探讨基于疾病诊断相关分组(DRGS)改革对医保患者住院费用的影响。方法 选取2020年7月至2021年6月我院在基于DRGS改革前收治的住院患者168例作为对照组,另选取2021年7月至2022年6月我院采取基于DRGS改革期间收治的住院患者168例作为观察组。比较两组患者的住院费用,主要病种平均住院费用,平均住院日和患者满意度情况。结果 观察组的诊疗费、检验检查费、手术治疗费、药物费和耗材费均少于对照组,差异均有统计学意义(均P<0.05)。观察组的股骨颈骨折、慢性阻塞性肺疾病、呼吸系统感染、脑梗死后遗症、急性阑尾炎等主要病种的平均住院费用均少于对照组,股骨颈骨折、慢性阻塞性肺疾病、呼吸系统感染、脑梗死后遗症、急性阑尾炎等主要病种的平均住院日均短于对照组,差异均有统计学意义(均P<0.05)。观察组患者的满意度高于对照组,差异有统计学意义(P<0.05)。结论 基于DRGS改革进一步促进精细化管理,减少了医保患者的住院费用,达到便民、利民的效果,从而获得更高的患者满意度。

Objective To explore the impact of the reform based on disease diagnosis related grouping(DRGS)on hospitalization expenses of medical insurance patients.Methods A total of 168 patients admitted to our hospital from July 2020 to June 2021 before the DRGs-based reform were selected as the control group,and another 168 patients admitted to our hospital from July 2021 to June 2022 during the DRGs-based reform were selected as the observation group.The hospitalization costs,average hospitalization costs for major diseases,average hospitalization days and patient satisfaction were compared between the two groups.Results The cost of diagnosis and treatment in the observation group was(786.68±16.63)yuan,the cost of inspection was(1392.84±12.35)yuan,the cost of surgical treatment was(379.95±5.54)yuan,the cost of drugs was(1098.82±15.52)yuan and the cost of consumables was(138.76±8.29)yuan,all less than that of the control group(P<0.05 for each).The average hospitalization expenses for major diseases such as femoral neck fracture,chronic obstructive pulmonary disease,respiratory system infection,sequelae of cerebral infarction,and acute appendicitis in the observation group were(6117.84±105.27)yuan,(6546.28±48.36)yuan,(6072.83±38.98)yuan,respectively.yuan,(7557.87±36.86)yuan,and(3000.66±18.34)yuan,all lower than that of the control group.The average hospitalization for major diseases such as femoral neck fracture,chronic obstructive pulmonary disease,respiratory infection,sequelae of cerebral infarction,and acute appendicitis the days were(10.79±1.02)d,(10.78±2.10)d,(10.76±2.14)d,(11.02±3.15)d,(5.02±0.98)d,all shorter than that of the control group(P<0.05 for each).The patient satisfaction in the observation group(98.21%)was higher than that in the control group(92.86%)(P<0.05).Conclusion Based on the DRGS reform,further promotion of refined management can reduce the hospitalization expenses of medical insurance patients,achieve the effect of convenience and benefit for the people,and thus obtain higher patient satisfaction.