摘要
目的:以下肢静脉曲张为例,分析同一疾病诊断相关分组(DRG)行双侧手术与单侧手术的费用差异,探索同台双侧手术DRG支付时进行系数调整的必要性。方法:选取北京某三级医院2017年至2019年DRG分组为FJ25(静脉系统复杂手术,不伴合并症与伴随病)的全部出院患者病案首页信息,比较进行单侧手术和双侧手术的费用差异。结果:共纳入359例患者,其中单侧手术组230例(64.07%),双侧手术组129例(35.93%)。单侧手术组和双侧手术组患者性别、年龄、住院天数比较差异无统计学意义( P>0.05)。双侧手术组住院费用高于单侧手术组( P<0.05),费用差异主要来源于耗材费、手术费、麻醉费和药品费用,两组诊疗费和检验费用比较差异无统计学意义( P>0.05)。双侧手术组医保患者的个人负担高于单侧手术组。 结论:同一DRG组内,进行同台双侧手术在医保支付时可应用调整系数进行调整,以避免临床分解住院行为的发生。
Objective To analyze the cost difference between bilateral surgery and unilateral surgery in the same diagnosis-related group(DRG),and to explore the necessity of coefficient adjustment in DRG payment for bilateral surgery.Methods The medical record frontpage information of all discharged patients who were divided into FJ25(complicated operation of venous system,without complications and accompanying diseases)by DRG in a tertiary hospital from 2017 to 2019 was selected,and the cost difference between unilateral operation and bilateral operation was compared.Results A total of 359 patients were included,including 230 patients(64.07%)in unilateral operation group and 129 patients(35.93%)in bilateral operation group.There was no significant difference in gender,age and length of hospital stay between unilateral operation group and bilateral operation group(P>0.05).The hospitalization expenses of the bilateral operation group were higher than those of the unilateral operation group(P<0.05),and the differences mainly came from the expenses of consumables,operation,anesthesia and drugs.There was no significant difference in the expenses of diagnosis and treatment,and the cost of inspection between the two groups(P>0.05).The individual burden of patients with medical insurance in bilateral operation group was higher than that in unilateral operation group.Conclusions In the same DRG group,the adjustment coefficient can be used to adjust the medical insurance payment for bilateral surgery,so as to avoid the occurrence of clinical decomposition hospitalization behavior.
作者
许欣悦
高广颖
唐佳骥
陈欣
张彤彦
Xu Xinyue;Gao Guangying;Tang Jiaji;Chen Xin;Zhang Tongyan(Medical Insurance Office,Beijing Tongren Hospital,Capital Medical University,Beijing 100730,China;Capital Medical University Public Health School,Beijing 100069,China;Department of Vascular Surgery,Beijing Tongren Hospital,Capital Medical University,Beijing 100730,China)
出处
《中华医院管理杂志》
CSCD
北大核心
2021年第3期199-202,共4页
Chinese Journal of Hospital Administration
关键词
外科手术
双侧
疾病诊断相关分组
支付
系数
Surgical procedures,operative
Bilateral
Diagnosis-related groups
Payment
Coefficient
