DRG(Diagnosis Related Group,DRG)付费是当前国家重点推进的医保支付改革方式,其核心是按照疾病诊断分组权重予以医保费用结算。皮肤科病种繁多,整体病组权重低,导致支付标准较低。如何在DRG支付方式改革背景下,更好运营发展、提供高...DRG(Diagnosis Related Group,DRG)付费是当前国家重点推进的医保支付改革方式,其核心是按照疾病诊断分组权重予以医保费用结算。皮肤科病种繁多,整体病组权重低,导致支付标准较低。如何在DRG支付方式改革背景下,更好运营发展、提供高质量诊疗服务,是当前皮肤病专科医院及皮肤科面临的一个挑战。本文拟基于我院数据,从DRG管理体系建立包括病种运营管理、病种成本控制、调整收入结构、规范路径管理、加强科室运营管理,同时提升病案首页质量和编码的准确性、开展日间病房与日间手术、与医保经办机构加强沟通、优化信息系统建设等方面,为皮肤科DRG付费下的运营模式提供参考。展开更多
In south China, warm-sector rainstorms are significantly different from the traditional frontal rainstorms due to complex mechanism, which brings great challenges to their forecast. In this study, based on ensemble fo...In south China, warm-sector rainstorms are significantly different from the traditional frontal rainstorms due to complex mechanism, which brings great challenges to their forecast. In this study, based on ensemble forecasting, the high-resolution mesoscale numerical forecast model WRF was used to investigate the effect of initial errors on a warmsector rainstorm and a frontal rainstorm under the same circulation in south China, respectively. We analyzed the sensitivity of forecast errors to the initial errors and their evolution characteristics for the warm-sector and the frontal rainstorm. Additionally, the difference of the predictability was compared via adjusting the initial values of the GOOD member and the BAD member. Compared with the frontal rainstorm, the warm-sector rainstorm was more sensitive to initial error, which increased faster in the warm-sector. Furthermore, the magnitude of error in the warm-sector rainstorm was obviously larger than that of the frontal rainstorm, while the spatial scale of the error was smaller. Similarly, both types of the rainstorm were limited by practical predictability and inherent predictability, while the nonlinear increase characteristics occurred to be more distinct in the warm-sector rainstorm, resulting in the lower inherent predictability.The comparison between the warm-sector rainstorm and the frontal rainstorm revealed that the forecast field was closer to the real situation derived from more accurate initial errors, but only the increase rate in the frontal rainstorm was restrained evidently.展开更多
文摘DRG(Diagnosis Related Group,DRG)付费是当前国家重点推进的医保支付改革方式,其核心是按照疾病诊断分组权重予以医保费用结算。皮肤科病种繁多,整体病组权重低,导致支付标准较低。如何在DRG支付方式改革背景下,更好运营发展、提供高质量诊疗服务,是当前皮肤病专科医院及皮肤科面临的一个挑战。本文拟基于我院数据,从DRG管理体系建立包括病种运营管理、病种成本控制、调整收入结构、规范路径管理、加强科室运营管理,同时提升病案首页质量和编码的准确性、开展日间病房与日间手术、与医保经办机构加强沟通、优化信息系统建设等方面,为皮肤科DRG付费下的运营模式提供参考。
基金National Key Research and Development Program of China(2017YFC1502000)。
文摘In south China, warm-sector rainstorms are significantly different from the traditional frontal rainstorms due to complex mechanism, which brings great challenges to their forecast. In this study, based on ensemble forecasting, the high-resolution mesoscale numerical forecast model WRF was used to investigate the effect of initial errors on a warmsector rainstorm and a frontal rainstorm under the same circulation in south China, respectively. We analyzed the sensitivity of forecast errors to the initial errors and their evolution characteristics for the warm-sector and the frontal rainstorm. Additionally, the difference of the predictability was compared via adjusting the initial values of the GOOD member and the BAD member. Compared with the frontal rainstorm, the warm-sector rainstorm was more sensitive to initial error, which increased faster in the warm-sector. Furthermore, the magnitude of error in the warm-sector rainstorm was obviously larger than that of the frontal rainstorm, while the spatial scale of the error was smaller. Similarly, both types of the rainstorm were limited by practical predictability and inherent predictability, while the nonlinear increase characteristics occurred to be more distinct in the warm-sector rainstorm, resulting in the lower inherent predictability.The comparison between the warm-sector rainstorm and the frontal rainstorm revealed that the forecast field was closer to the real situation derived from more accurate initial errors, but only the increase rate in the frontal rainstorm was restrained evidently.
