DRG基础病组住院费用及影响因素分析——以IF59病组为例

Analysis of Hospitalization Expenses and Influencing Factors in the DRG Basic Disease Group——Taking IF59 Disease Group as an Example

目的:比较分析某三甲医院IF59基础病组2022年和2023年运行情况,评价医院DRG管理措施的实施效果,为医院精细化管理和高质量发展提供参考。方法:对458例IF59病组的住院费用、患者自付费用、药耗占比、住院天数、临床路径管理、病组盈亏等进行描述性分析;运用多元线性回归对住院费用的影响因素进行分析。结果:2023年案例医院IF59病组的次均住院费用、患者自付费用、药耗占比、例均亏损额等指标较2022年明显好转;多元线性回归分析显示手术部位的个数、患者年龄、住院天数、材料费、手术费、药品费、是否执行临床路径是影响IF59病组住院费用的主要因素。结论:案例医院DRG管理取得初步成效,但IF59病组仍在亏损,运营管理仍面临诸多挑战,医院要根据自身功能定位,进一步明确基础病组管理策略,构建基于DRG的临床路径管理体系,持续提升科室精细化管理水平,不断规范医疗行为。

Objective:To compare and analyze the operation of IF59 basic disease group in a certain grade Atertiary hospital in 2022 and 2023,and evaluate the implementation effect of DRG management measures in the hospital,so as to provide references for fine management and high-quality development of the hospital.Methods:Descriptive analysis was performed on the hospitalization expenses,patient out-of-pocket expenses,drug consumption ratio,hospitalization days,clinical pathway management,and profit and loss of the 458 IF59 disease group.Multivariate linear regression was used to analyze the influencing factors of hospitalization expenses.Results:In 2023,the average hospitalization expenses per time,self-paid expenses of patients,proportion of drug consumption,average loss per case and other indicators of IF59 disease group in case hospitals were significantly better than those in 2022.Multivariate linear regression analysis showed that the number of surgical sites,age,length of hospital stay,material costs,surgical costs,drug costs,and the implementation of clinical pathways were the main factors of hospitalization costs in the IF59 disease group.Conclusion:The DRG management of the case hospital has achieved initial results,but the IF59 disease group is still losing money,and the operation management still faces many challenges.The hospital should further clarify the management strategy of basic disease group according to its own functional positioning,build a DRG-based clinical path management system,continuously improve the fine management level of the department,and constantly standardize the medical behavior.