摘要
目的探讨按疾病诊断相关分组(DRGs)视角下控费政策对医疗服务的影响。方法以“嘉定区域疾病诊断相关分组医疗服务管理系统”为研究平台,对某二级医院2017—2018年住院患者DRGs相关的DRG组数、病例组合指数值(CMI)、时间消耗指数、费用消耗指数等指标进行比较分析。结果DRGs组数从390增加到394;总权重从9 198.37增加到9 372.3;CMI从0.76增加到0.83;时间消耗指数从1.05降低到0.98;费用效率指数从1降低到0.93;低风险死亡率由0上升为0.34%;中低风险死亡率由10.16%降低为7.4%;病种难易程度监管指标(RW)≥2例数占本院总例数的比重由1.78%上升到4.43%。结论通过DRGs对控费政策下住院患者的服务能力、服务效率和安全进行评价具有科学、合理和公平的特点,DRGs评价体系也可以成为控费政策下加强医疗服务管理的有效工具。
Objective To explore the impact of cost control policy on medical services from the perspective of DRGs. Methods Based on the "Jiading Regional Disease Diagnosis Related Grouping Medical Service Management System", the DRGs-related DRG groups, case mix index (CMI), time consumption index and cost consumption index of inpatients in a secondary hospital in 2017 and 2018 were compared and analyzed. Results DRGs group increased from 390 to 394;total weight increased from 9 198.37 to 9 372.3;CMI increased from 0.76 to 0.83;time consumption index decreased from 1.05 to 0.98;cost efficiency index decreased from 1 to 0.93;low risk mortality increased from 0 to 0.34%;middle and low risk mortality decreased from 10.16% to 7.4%;RW≥2 cases accounted for the total number of hospitals. The proportion of cases (%) increased from 1.78 to 4.43. Conclusion It is scientific, reasonable and fair to evaluate the service ability, service efficiency and safety of inpatients under the cost control policy by DRGs. The DRGs evaluation system can also be an effective tool to strengthen the management of medical services under the cost control policy.
作者
周海龙
封卫征
汤洁
钱丽静
朱晓玲
厉海洋
金莉莎
Zhou Hailong;Feng Weizheng;Tang Jie;Qian Lijing;Zhu Xiaoling;Li Haiyang;Jin Lisha(Department of Medical Services,Nanxiang Hospital,Jiading District,Shanghai 201802,China)
出处
《山西医药杂志》
CAS
2019年第20期2466-2469,共4页
Shanxi Medical Journal
基金
上海市嘉定区科委科研项目（JDKW-2019-W12）
2018年上海市医院协会医疗保险管理专业委员会课题
