DRGs付费实施对广西某院人工髋关节置换术患者住院费用影响分析

Analysis of the Impact of the Implementation of DRGs Payment on Hospitalization Costs for Patients Undergoing Artificial Hip Replacement in a Hospital in Guangxi

目的分析广西某院在DRGs实施前后人工髋关节置换术患者住院费用的变化情况,为精细化控制住院费用提供数据参考。方法选取DRGs付费政策实施前2020年1月1日-2020年12月31日和DRGs付费政策实施后2021年1月1日-2021年12月31日广西某院施行人工髋关节置换术的490例住院患者的性别、年龄、住院时间和住院费用等相关数据,采用T检验、χ^(2)检验和非参数Z检验进行统计分析。结果DRGs付费政策实施后住院各项费用下降最明显的是药费,由实施前7612.53元下降至5329.64元,其次是材料费,由实施前38187.15元下降至31895.43元。治疗费和护理费占比较实施前分别增长了1.88%和0.07%。其中实施前后的输血费的差异不具有统计学意义,总费用、床位费、检查费、治疗费、护理费、手术费、检验费、材料费、药费和其他费的差异具有统计学意义。平均住院日实施前12.11(10.01,16.69)天,实施后10.49(8.60,13.73)天,差异具有统计学意义。结论DRGs付费政策实施对人工髋关节置换术住院费用构成影响明显,其中实施后药费、材料费占比下降,治疗费和护理费占比提高,提高医护人员技术劳动价值,有效控制住院费用增长,为推行DRGs付费政策的实施打下坚实的基础。

Objectives This study aims to explore the changes in hospitalization expenses of patients undergoing artificial hip replacement before and after the implementation of DRGs in a hospital in Guangxi,so as to provide a data reference for refined control of hospitalization expenses.Methods 490 cases of artificial hip replacement in a hospital in Guangxi from January 1,2020 to December 31,2020 before the implementation of the DRGs payment policy and from January 1,2021 to December 31,2021 after the implementation of the DRGs payment policy were selected.Relevant data such as gender,age,length of stay,and hospitalization expenses of inpatients were extracted.Statistical analysis was performed using T test,χ^(2) test,and non-parametric Z test.Results After the implementation of the DRGs payment policy,the most obvious decrease in hospitalization expenses was the cost of medicine,which dropped from 7612.53 yuan before implementation to 5329.64 yuan,followed by the cost of materials,which dropped from 38187.15 yuan before implementation to 31895.43 yuan.The proportion of treatment fees and nursing fees increased by 1.88%and 0.07%respectively compared with before implementation.The difference in blood transfusion costs before and after implementation was not statistically significant.The differences in total cost,bed fee,examination fee,treatment fee,nursing fee,surgery fee,examination fee,material fee,medicine fee,and other fees were statistically significant.The average hospitalization days were 12.11(10.01,16.69)days before implementation and 10.49(8.60,13.73)days after implementation,and the difference was statistically significant.Conclusions The implementation of DRGs payment policy had a significant impact on the hospitalization expenses of artificial hip replacement surgery.After the implementation,the proportion of drug expenses and material expenses decreased,while the proportion of treatment expenses and nursing expenses increased.This can improve the value of the technical labor of medical staff,effectively control the growth of hospitalization expenses,and lay a solid foundation for the implementation of the DRGs payment policy.