基于双重差分法的艾滋病患者DRG控费效果评价

Evaluation of Cost Control Effect of DRG for AIDS Patients based on Differences-in-Differences Method

目的:分析疾病诊断相关分组(diagnosis-related groups,DRGs)付费改革前后艾滋病患者住院费用的变化,提出相应成本管控建议。方法:运用双重差分法(Differences-in-Differences,DID)对某三甲传染病医院4394份艾滋病病例的住院费用及住院天数进行平均效应分析。结果:DRG付费实施后,艾滋病患者的住院总费用和耗材费下降明显(P <0.05),药品费、检查费等无明显变化(P> 0.05),平均住院天数减少2.53天(P <0.05)。结论:应进一步强化艾滋病药品及检查的控费力度,建议通过搭建信息监控平台、实行院内评审、规范检查流程、应用创新技术等举措,完善艾滋病住院费用的精细化管理。

Objective:The changes of hospitalization expenses of AIDS patients before and after the payment reform of disease diagnosis-related groups(DRGs)were analyzed,and the corresponding cost control suggestions were put forward.Methods:Taking 4,394 AIDS cases in a certain tertiarygrade A infectious disease hospital as the research object,the double difference method(Differencesin-Differences,DID)was used to analyze the average effect of hospitalization cost and hospitalization days.Results:After the implementation of DRG payment,the total hospitalization cost and consumable cost of AIDS patients decreased significantly(P<0.05),the drug cost and examination fee had no significant change(P>0.05),and the average hospitalization days decreased by 2.53 days(P<0.05).Conclusion:The cost control of AIDS drugs and inspection should be further strengthened.It is suggested to strengthen the fine management of AIDS hospitalization expenses by building an information monitoring platform,conducting in-hospital reviews,standardizing the inspection process,and applying innovative technologies.