疾病诊断相关分组支付方式对三甲中医院财务管理的影响及应对策略

The Impact and Corresponding Strategies of Diagnosis Related Groups Payment Method on the Financial Management of Class A Tertiary Hospital of Traditional Chinese Medicine

探讨了疾病诊断相关分组(DRG)支付方式对三甲中医院财务管理的影响并提出应对策略。结合所在医院随机抽取的某月各科室相关数据,运用DRG支付方式下的相应指标并结合波士顿矩阵理论模型进行全面综合评价分析。2023年1月,所在医院5个科室CMI值高于全院平均水平,且盈余情况良好;8个科室CMI值低于全院平均水平,但有盈余;14个科室CMI值低于全院平均水平,且还有亏损;8个科室CMI值高于全院平均水平,却有亏损。DRG支付方式对三甲中医院来说,既是机遇也是挑战,对三甲中医院信息化数据系统、成本核算精细化提出高要求,对预算管理、拓展收入增长内涵提出新要求。三甲中医院应重视病案质量主体培训,强化成本内控,转为质量效益型运营管理模式,应用临床路径以“提质控费”,发挥中医药优势学科,结合中医治疗特点来制定适合中医发展的DRG支付方式。

This paper discussed the impact of diagnosis related groups(DRG)payment methods on the financial management of class A tertiary hospital of traditional Chinese medicine(TCM)and proposed corresponding strategies.Based on the randomly selected data of various departments in the hospital for a certain month,a comprehensive evaluation and analysis was conducted using the corresponding indicators under the DRG payment method and the Boston Matrix Theory model.In January 2023,the CMI values of five departments in the hospital were higher than the average level of the entire hospital,and the surplus situation was good.The CMI values of 8 departments were lower than the average level of the entire hospital,but there was a surplus.14 departments had CMI values lower than the average level of the entire hospital,and there were also losses.The CMI values of 8 departments were higher than the average level of the entire hospital,but there were losses.The DRG payment method is both an opportunity and a challenge for class A tertiary TCM hospital.It poses high requirements for the information data system and cost accounting refinement of class A tertiary TCM hospitals,as well as new requirements for budget management and expanding the connotation of revenue growth.The class A tertiary TCM hospitals should attach great importance to training the main body of medical record quality,strengthen cost internal control,shift to a quality and efficiency oriented operation and management model,apply clinical pathways to"improve quality control fees",leverage the advantages of TCM disciplines,and combine the characteristics of TCM treatment to develop DRG payment methods suitable for the development of TCM.