[1]陶 洋,王芳芳,朱晨晨,等.DRG付费法下晶体手术组盈亏的影响因素分析[J].医学信息,2022,35(11):5-7.[doi:10.3969/j.issn.1006-1959.2022.11.002]
　TAO Yang,WANG Fang-fang,ZHU Chen-chen,et al.Analysis of Influencing Factors of Surplus for Crystal Surgery Group Under DRG Payment Method[J].Medical Information,2022,35(11):5-7.[doi:10.3969/j.issn.1006-1959.2022.11.002]
点击复制

DRG付费法下晶体手术组盈亏的影响因素分析()
分享到：

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
35卷
期数:
2022年11期
页码:
5-7
栏目:
卫生管理信息学
出版日期:
2022-06-01

文章信息/Info

Title:
Analysis of Influencing Factors of Surplus for Crystal Surgery Group Under DRG Payment Method
文章编号:
1006-1959（2022）11-0005-03
作者:
陶 洋; 王芳芳; 朱晨晨; 等
（宁波大学附属人民医院病案统计室，浙江 宁波 315000）
Author(s):
TAO Yang; WANG Fang-fang; ZHU Chen-chen; et al.
(Department of Medical Record Statistics,The Affiliated People’s Hospital of Ningbo University,Ningbo 315000,Zhejiang,China)
关键词:
疾病诊断相关分组; 点数法付费; 晶体手术; 盈亏分析
Keywords:
Diagnosis related groups; Pay by points; Crystal surgery; Profit and loss analysis
分类号:
R197
DOI:
10.3969/j.issn.1006-1959.2022.11.002
文献标志码:
A
摘要:
目的 探讨宁波某院影响晶体手术疾病诊断相关分组（DRG）盈亏的相关因素。方法 根据宁波市某院2021年1月-6月医保DRG系统的分组结果，收集1383例晶体手术的住院病例的病案首页信息，将其根据医保盈余情况分为盈余组（629例）与亏损组（754例），使用单因素和多因素线性回归方法分析住院病例特点及分项费用与医保盈余的相关性。结果 盈余组与亏损组的年龄、术前住院天数、住院天数、性别比较，差异无统计学意义（P＞0.05）；两组的手术分期及诊疗组的分布比较，差异有统计学意义（P＜0.05）；分项费用中住院费用明细中治疗费、西药费、耗材费与盈余额呈负相关，其他费用与盈余额呈微弱正相关（P＜0.05）；经多元线性回归构建的盈余模型：盈余额度=7318.779-1.038×综合服务费-1.017×诊断费-1.025×治疗费-0.243×西药费-1.005×耗材费，标准化各单项费用后，耗材费对盈余额度的影响最大。结论 降低单眼晶体手术DRG组费用的关键在于加强耗材管理，合理控制耗材费用。
Abstract:
Objective To explore the related factors affecting the surplus for crystal surgery of diagnosis related groups (DRG) in a hospital in Ningbo.Methods According to the grouping results of medical insurance DRG system in a hospital in Ningbo from January to June 2021, the first page information of medical records of 1383 hospitalized patients with crystal surgery was collected. And according to the medical insurance surplus, they were divided into surplus group (629 cases) and deficit group (754 cases). Single factor and multi-factor linear regression methods were used to analyze the correlation between the characteristics of hospitalized patients and the sub-cost of medical insurance surplus.Results There were no significant differences between the surplus group and the deficit group in age, preoperative hospitalization days, hospitalization days and gender (P>0.05), whereas there were statistically significant differences in surgical stages and distribution of the diagnosis and treatment group (P<0.05). In the details of hospitalization expenses, treatment expenses, medicine expenses and consumables expenses were negatively correlated with the surplus balance, while other expenses were slightly positively correlated with the surplus balance (P<0.05). The surplus model constructed by multiple linear regression was as follows: surplus amount=7318.779-1.038×comprehensive service expenses-1.017×diagnosis expenses-1.025×treatment expenses-0.243×medicine expenses -1.005×consumables expenses. After standardizing details of expenses, consumables expenses had the greatest influence on surplus amount.Conclusion The key to reduce the cost of DRG is to strengthen the management of consumables and rationally control the cost of consumables.

参考文献/References:

[1]李乐乐.国内外DRGs发展与C-DRG方法论原理改进研究[J].卫生软科学,2017,31(10):10-14.[2]郭志伟.DRGs的原理与方法及在我国的应用对策[J].中国卫生经济,2010(8):37-39.[3]鲍玉荣,朱士俊,郝娟.按DRGs付费在我国的应用前景分析[J].中华医院管理杂志,2010,26(10):721-724.[4]周海龙,田源,封卫征,等.基于DRG的医疗服务质量与绩效评价干预模式研究[J].中国初级卫生保健,2020(8):26-30. [5]杨翼帆,王淑慧,杨凡,等.DRG支付方式下医院管理模式探索[J].中国卫生标准管理,2021(3):25-28.[6]Vladeck BC.Medicare Hospital Payment by Diagnosis-Related Groups[J].Annals of Internal Medicine,1984,100(4):576-591.[7]杨柳,问肃生,汪渠.基于DRGs的公立医院绩效评价研究[J].医学信息,2020,33(19):5-8.[8]潘俊,孙国岩,谢华王.《政府会计制度》实施下医院成本管理模式探析[J].中国卫生经济,2019,38(7):82-85.[9]周海平.医疗服务项目叠加法病种成本核算探索[J].新会计,2016(7):71-72.[10]沈红.作业成本法在医疗服务项目成本核算中的运用[J].中医药管理杂志,2011,19(12):1136-1139.[11]崔盼.我国公立医院DRGs病种系列成本核算方法探讨[J].财经界,2019(10):117-119.[12]鲁一鸣.基于病历成本法的DRG成本应用[J].中国总会计师,2019(8):68-69.[13]徐秋萍.啃下成本管理的“硬骨头”——基于DRG收付费改革下深圳南山医院DRG病组成本核算实践[J].中国质量,2020,471(9):52-56.[14]朱培渊.DRG支付方式改革在公立医院的实施路径探讨[D].北京:中国人民解放军医学院,2018.

相似文献/References:

[1]高 峰,刘 颜.DRG实施的难点及解决对策[J].医学信息,2022,35(11):1.[doi:10.3969/j.issn.1006-1959.2022.11.001]
　GAO Feng,LIU Yan.Difficulties and Solutions of DRG Implementation[J].Medical Information,2022,35(11):1.[doi:10.3969/j.issn.1006-1959.2022.11.001]
[2]万映利,宋 萍.基于CiteSpace的国内外DRG热点分析及其发展建议[J].医学信息,2020,33(05):9.[doi:10.3969/j.issn.1006-1959.2020.05.003]
　WAN Ying-li,SONG Ping.Hot Spot Analysis of DRG at Home and Abroad Based on CiteSpace and Its Development Suggestions[J].Medical Information,2020,33(11):9.[doi:10.3969/j.issn.1006-1959.2020.05.003]
[3]顾梦佳,蔡 斌,余 靓.运用DRGs指标综合评估医院质量及临床绩效的研究[J].医学信息,2021,34(14):22.[doi:10.3969/j.issn.1006-1959.2021.14.006]
　GU Meng-jia,CAI Bin,YU Liang.Research on Comprehensive Evaluation of Hospital Quality and Clinical Performance Using DRGs Index[J].Medical Information,2021,34(11):22.[doi:10.3969/j.issn.1006-1959.2021.14.006]
[4]李 杰,单思哲,杨 波,等.基于“军字一号”工程的DRG医院支付管理系统的设计与应用[J].医学信息,2022,35(03):17.[doi:10.3969/j.issn.1006-1959.2022.03.004]
　LI Jie,Shan Si-zhe,YANG Bo,et al.Design and Application of DRG Hospital Payment Management SystemBased on "No.1 Military Project"[J].Medical Information,2022,35(11):17.[doi:10.3969/j.issn.1006-1959.2022.03.004]
[5]陶 洋,王芳芳,朱晨晨,等.基于TOPSIS法与RSR法对外科绩效评价的对比分析[J].医学信息,2023,36(14):48.[doi:10.3969/j.issn.1006-1959.2023.14.009]
　TAO Yang,WANG Fang-fang,ZHU Chen-chen,et al.Comparative Analysis of Surgical Performance Evaluation Based on TOPSIS and RSR[J].Medical Information,2023,36(11):48.[doi:10.3969/j.issn.1006-1959.2023.14.009]
[6]詹汉强,魏鑫然.基于DRG/DIP支付背景下病种分值付费的研究[J].医学信息,2023,36(15):100.[doi:10.3969/j.issn.1006-1959.2023.15.019]
　ZHAN Han-qiang,WEI Xin-ran.Research on Disease Score Payment Based on DRG/DIP Payment Mode[J].Medical Information,2023,36(11):100.[doi:10.3969/j.issn.1006-1959.2023.15.019]
[7]汤 鑫,刘 颜.国内外DRG实践发展及其对我国的启示[J].医学信息,2023,36(21):27.[doi:10.3969/j.issn.1006-1959.2023.21.006]
　TANG Xin,LIU Yan.Development of DRG Practice at Home and Abroad and its Enlightenment to China[J].Medical Information,2023,36(11):27.[doi:10.3969/j.issn.1006-1959.2023.21.006]
[8]张 晋,王 伟.基于DRG的股骨颈骨折治疗临床路径优化效果观察[J].医学信息,2024,37(13):56.[doi:10.3969/j.issn.1006-1959.2024.13.011]
　Observation on the Optimization Effect of Clinical Pathway for Femoral Neck Fracture Treatment Based on DRG.Observation on the Optimization Effect of Clinical Pathway for Femoral Neck Fracture Treatment Based on DRG[J].Medical Information,2024,37(11):56.[doi:10.3969/j.issn.1006-1959.2024.13.011]

更新日期/Last Update: 1900-01-01