摘要
目的:通过分析评价山东某三甲医院单病种付费实施现状,探讨单病种付费存在的问题,以及对即将实施的按疾病诊断相关分组(DRG)付费带来的启示。方法:采用率和频数来描述比较不同年份单病种病人住院费用超限额情况。结果:2017年-2020年,该医院市医保单病种次均住院费用超限额病种数较多(超过50%),脑肿瘤手术治疗单病种次均住院费用每年均高于限额,且住院费用中卫生材料费占比最大。结论:医院应加强DRG付费管理工作,规范完善临床路径,同时管理部门应确立科学合理的DRG付费标准,建立灵活动态的DRG付费调整机制。
Objective:Through analyzing and evaluating the current status of single disease payment in a tertiary hospital in Shandong,this paper discusses the problems of single disease payment and the enlightenments for DRG payment which will be implemented soon.Methods:The rate and frequency are used to describe and compare the hospitalization expenses and over-limit conditions of single disease patients in diff erent years.Results:From 2017 to 2020,the number of single diseases with the average hospitalization expenses per time exceeding the limit is more than 50%.Among the single diseases,average hospitalization expenses for brain tumor surgery are higher than the limit every year,and the proportion of health materials expenses in the hospitalization expenses is the largest.Conclusion:Hospitals should strengthen the management of DRG payment,standardize and improve clinical pathways,and the management department should establish a scientifi c and reasonable DRG payment standard,establish a fl exible and dynamic DRG payment adjustment mechanism.
作者
王奉香
王孝勇
Wang Fengxiang;Wang Xiaoyong(Provincial Hospital Affi liated to Shandong First Medical University,Jinan,250021)
出处
《中国医疗保险》
2021年第6期63-65,共3页
China Health Insurance
