DRGs实施前后的急性心肌梗死患者住院费用分析

Analysis of hospitalization expenses of patients with acute myocardial infarction before and after implementation of DRGs

目的分析某院急性心肌梗死患者在实行DRG付费前后住院费用的差异,为合理有效控制心肌梗死患者住院费用增长提供参考依据。方法分别提取某院DRG付费前2020年1月1日-2020年9月30日和DRG付费后2021年1月1日-2021年9月30日住院患者中主要诊断是心肌梗死共1005例的病案首页信息,录入Excel数据库,并运用SPSS22.0统计软件对DRGs付费组和非DRG付费组中6项住院费用采用T检验和非参数检验进行统计差异性分析。结果急性心肌梗死患者的住院费用在DRG实施后比DRG实施前明显下降,人均住院总费用减少了19428.47元,下降率39.36%、人均手术材料费减少18856.65元,下降率79.78%、人均药费减少2646元,下降率53.33%、人均检查费减少1344.12元,下降率26.17%,运用T检验分析结果得出P<0.0001,差异具有统计学意义。住院费用构成比中,DRGs付费后手术材料费构成比下降明显,下降了31.92%,而治疗费、其他费用、检查费、西药费略呈上升趋势。结论急性心肌梗死患者在实施DRG付费后有效降低人均住院费用、人均西药费、手术材料费及检查费,医疗费用控制总体效果理想。

Objectives This study aims to analyze the difference in hospitalization expenses of patients with acute myocardial infarction in a hospital before and after the implementation of DRG payment,and provide a reference for reasonable and effective control of the increase in hospitalization expenses of patients with myocardial infarction.Methods A total of 1005 cases of myocardial infarction were extracted from the inpatients in a hospital from January 1,2020 to September 30,2020 before DRG payment and from January 1,2021 to September 30,2021 after DRG payment.Information on the front pages of their medical records was entered into the EXCEL database.SPSS22.0 statistical software was used to analyze the statistical difference of 6 items of hospitalization expenses between the DRGs paying group and the non-DRG paying group using T test and non-parametric test.Results The hospitalization expenses of patients with acute myocardial infarction decreased significantly after the implementation of DRG than before the implementation of DRG.The total hospitalization expenses per capita decreased by 19,428.47 yuan,with a drop rate of 39.36%.Per capita cost of surgical materials decreased by 18,856.65 yuan,with a drop rate of 79.78%.Per capita drug expenses decreased by 2,646 yuan,with a drop rate of 53.33%.Per capita inspection fees decreased by 1,344.12 yuan,with a drop rate of 26.17%.T test was used to analyze the results.P value was less than 0.0001,which was statistically significant.In the composition ratio of hospitalization expenses,the composition ratio of surgical material expenses decreased significantly after DRGs paid,by 31.92%,while treatment expenses,other expenses,examination fees,and western medicine expenses showed a slight upward trend.Conclusions For patients with acute myocardial infarction,after implementing DRG payment,the per capita hospitalization expenses,per capita western medicine expenses,surgical material expenses and examination expenses are effectively reduced.The overall effect of medical cost control is ideal.