DRG改革对公立医院住院服务效率及质量的影响

Study on the Effect of DRG Payment Reform on the Efficiency and Quality of Inpatient Services in Public Hospitals

目的:分析DRG改革对公立医院住院服务效率及质量的影响。方法:采用双重差分法,以T市为对照,检验L市实施DRG改革后,次均住院费用、平均住院日和30天再入院率的变化。结果:DRG改革显著降低了次均住院费用、平均住院日和30天再入院率。随着时间的推移,改革的控费作用消失,对平均住院日的改革效应有所减弱,对30天再入院率的改革效应逐步增强。结论:建立病组成本核算方法,平衡效率与质量的关系,完善长期监测与评估机制,确保DRG改革成效。

Objective To analyze the impact of DRG payment reform on the efficiency and quality of inpatient services in public hospitals.Methods Taking T city as a control,the difference in difference method was used to examine the changes of average hospitalization expenditure,average length of stay and 30-day readmission rate after the implementation of DRG reform in L city.Results During the study period,the reform significantly reduced the average hospitalization expenditure,the average length of stay and the 30-day readmission rate.With the passage of time,the expenditure control effect of the reform disappeared,the effect of reducing the average length of stay weakened,and the effect of reducing the 30-day readmission rate gradually increased.Conclusion Government departments should establish cost accounting methods for DRG,balance the relationship between efficiency and quality,and improve the long-term monitoring and evaluation mechanism to ensure the steady progress of reform.