DRG高倍率病例与正常倍率病例差异及住院费用灰色关联分析

Grey correlation analysis of the difference between DRG high rate and normal rate cases and hospitalization costs

目的:分析DRG高倍率病例与正常倍率病例差异,研究DRG高倍率病例住院费用主要影响因素,为高倍率病例有效控费、减轻患者医疗负担、促进医保基金合理使用提供科学依据。方法:对某院2021年DRG高倍率病例和正常倍率病例的患者基本信息及费用信息进行统计描述,采用灰色关联模型对比研究高倍率病例和正常倍率病例患者住院总费用的内部影响因素。结果:2021年案例医院DRG正常倍率病例28 800例,高倍率病例242例;高倍率病例与正常倍率病例患者在年龄、住院天数、基金类型、性别、出院情况、基准点数、住院总费用等方面的差异有统计学意义;高倍率病例住院总费用灰色关联分析相关度前3位依次为西药费、医疗服务费和实验室诊断费,正常倍率病例住院总费用灰色关联分析相关度前3位依次为医疗服务费、实验室诊断费和西药费。结论:应加强西药合理使用管理,减少不合理实验室检查,完善临床路径管理,提升医疗服务质量,从而有效控制高倍率病例住院总费用,减轻患者经济负担。

Objective:To analyze the differences between high DRG rate cases and normal DRG rate cases,to study the main influencing factors of hospitalization costs of high DRG rate cases,to provide a scientific basis for effective cost control of high DRG rate cases,reduce the medical burden of patients,and promote the rational use of medical insurance funds.Methods:The basic information and cost information of patients with high and normal rates of DRG in a hospital in 2021 were statistically described,and the internal influencing factors of the total hospitalization cost of patients with high and normal rates of DRG were compared by using the grey relational model.Results:There were 28800 normal rate cases and 242 high-rate cases of DRG in a hospital in 2021.There were statistically significant differences between high-rate cases and normal-rate cases in terms of age,length of stay,fund type,gender,discharge status,baseline points,and total hospitalization cost.In the gray correlation analysis,the top three of the total hospitalization expenses of patients with high rates were Western medicine expenses,medical service fees,and laboratory diagnosis fees,while the top three of the gray correlation analysis of total hospitalization expenses of patients with normal rate were medical service fee,laboratory diagnosis fee,and western medicine fee.Conclusion:It is necessary to strengthen the rational use of Western drugs,reduce unreasonable laboratory tests,improve clinical pathway management,and improve the quality of medical services,to effectively control the total hospitalization cost of patients with high incidence rates and reduce the economic burden of patients.