DIP付费方式下公立医院病种效益分析与探讨

Discussion on Disease Benefit Analysis in Public Hospitals Under the DIP Payment System

目的适应DRG/DIP医保支付方式改革,落实医院精细化管理,助力学科发展的同时提升医院竞争力。方法以F医院为例,开展院级病种效益分析并选取“高血压2级”和“高血压3级”进行成本分析,以查找病种效益不佳的原因。结果公立医院病种分散且诊治例数不多;病种盈亏参半,效益有待提高。结论科室成本管控不到位、科室间诊治效率不均衡、病种收入与资源耗费不匹配、病案首页质量欠佳是影响病种效益的主要因素。建议优化收入结构,重视成本管控,借助绩效工具提升病种效益。

Objective To adapt to the reform of DRG/DIP medical insurance payment method,implement the lean management of hospitals,and enhance the competitiveness of hospitals while helping the development of disciplines.Methods Taking Hospital F as an example,we conducted a hospital-level disease benefit analysis and selected"hypertension level 2"and"hypertension level 3"for cost analysis to find out the reasons for the inefficiency of disease groups.Results The number of diseases in public hospitals was fragmented and the number of cases treated was small.The profit and loss of the disease groups were mixed and the efficiency need to be improved.Conclusion Inadequate cost control in departments,imbalance in consultation and treatment efficiency among departments,mismatch between income and resource consumption in disease groups,and poor quality of the first page of medical records were the main factors affecting the efficiency of disease groups.It is recommended to optimize the income structure,pay attention to cost control,and use performance tools to improve the efficiency of disease groups.