基于DRG的中医院痔病住院费用研究

Study on Hospitalization Expenses of Hemorrhoids in Traditional Chinese Medicine Hospital Based on DRG

目的基于诊断相关分组(DRG)对中医院痔病患者的住院费用进行分析。方法收集本院肛肠科2020年5月-2022年10月收治的175例痔病患者的住院费用资料,比较不同临床特征患者的住院费用并确定住院费用的影响因素。参照DRG原则结合住院费用影响因素进行病例分组,计算变异系数(CV)评估病例组内部住院费用变异程度。结果175例痔病患者的住院时间在4~23 d,平均(12.68±3.42)d;住院费用在0.44万元~2.72万元,平均(1.32±0.35)万元。经Pearson相关分析,住院时间与住院费用呈显著正相关(r=0.476,P<0.001)。年龄>60岁、有合并症、住院时间>14 d的患者住院费用高于年龄≤60岁、无合并症及住院时间≤14 d的患者,差异有统计学意义(P<0.05)。合并症、住院时间是痔病患者住院费用的影响因素(P<0.05)。痔上直肠黏膜环切术有无合并症患者的住院费用比较,差异无统计学意义(P>0.05)。痔结扎术有合并症患者的住院费用高于无合并症患者,差异有统计学意义(P<0.05)。痔结扎术不伴合并症(DRG1组)、痔结扎术伴一般合并症(DRG2组)、痔结扎术伴严重合并症组(DRG3)、痔上直肠黏膜环切术(DRG4组)住院费用分别为(1.19±0.22)、(1.27±0.27)、(1.38±0.29)、(1.40±0.31)万元,CV均<1,说明组内一致性较高,分组效果理想。结论基于DRG可将中医院痔病患者分为4个不同病例组,各病例组住院费用情况可为痔病患者的住院费用提供参考。

Objective To analyze the hospitalization expenses of patients with hemorrhoids in traditional Chinese medicine hospital based on diagnosis related group(DRG).Methods The hospitalization expenses of 175 patients with hemorrhoids admitted to the anorectal department of our hospital from May 2020 to October 2022 were collected.The hospitalization expenses of patients with different clinical characteristics were compared and the influencing factors of hospitalization expenses were determined.According to the DRG principle and the influencing factors of hospitalization expenses,the cases were grouped,and the coefficient of variation(CV)was calculated to evaluate the degree of variation of hospitalization expenses within the case group.Results The hospitalization time of 175 patients with hemorrhoids was 4-23 days,with an average of(12.68±3.42)days;the hospitalization expenses ranged from 4400 yuan to 27200 yuan,with an average of(13200+3500)yuan.Pearson correlation analysis showed that there was a significant positive correlation between hospitalization time and hospitalization expenses(r-0.476).The hospitalization expenses of patients with age>60 years old,complications and hospitalization time>14 days were higher than those of patients with age≤60 years old,no complications and hospitalization time≤14 days,and the differences were statistically significant(P<0.05).Complications and hospitalization time were the influencing factorsof hospitalization expenses of patients with hemorrhoids(P<0.05).There was no significant difference in hospitalization expenses between patients with or without complications after rectal mucosal circumcision(P>0.05).The hospitalization cost of patients with complications was higher than that of patients without complications,and the difference was statistically significant(P<0.05).The hospitalization expenses of hemorrhoid ligation without complications(DRG1 group),hemorrhoid ligation with general complications(DRG2 group),hemorrhoid ligation with severe complications(DRG3 group),and hemorrhoidal rectal mucosal circumcision(DRG4 group)were(11900±2200),(12700±2700),(13800±2900),and(14000±3100)yuan,respectively.CV<l,indicating that the consistency within the group was high and the grouping effect was ideal.Conclusion Based on DRG,patients with hemorrhoids in traditional Chinese medicine hospitals can be divided into four dfferent case groups.The hospitalization expenses of each case group can provide reference for the hospitalization expenses of patients with hemorrhoids.