摘要
目的:通过试点城市5所医院结算数据,分析DRG支付改革前后关键指标变化情况,探究DRG支付改革效果。方法:首先通过双尾配对样本T检验验证新冠肺炎疫情与DRG支付方式改革对住院患者例均费用与平均住院日的影响显著与否,再通过因素分析法比较DRG支付改革下总费用和统筹支付费用下降的主要影响因素。结果:T检验下新冠肺炎疫情影响不显著,改革影响显著;经因素分析法分析,3所医院例均费用因素是总费用降低的主要影响因素,平均住院日是住院日降低的主要影响因素。结论:应注意DRG支付改革可能带来的转嫁费用等风险点,医保部门需加强监管;同时,医疗机构要积极转变思维与行为,更好适应DRG改革新形势。
Objective:Through the settlement data of five hospitals in DRG pilot cities,analyze the differences and changes of key indicators before and after the DRG payment reform,and explore the effect of the payment reform.Methods:Two-tailed paired sample T-test was used to verify whether the COVID-19 epidemic and DRG payment reform had significant effects on the average cost of hospitalized patients and the average length of hospital stay.Factor analysis was used to compare the main influencing factors of the total cost and the overall payment cost reduction under the payment reform.Results:Under the T-test,the impact of the COVID-19 epidemic was not significant,but the impact of the reform was significant.After decomposing by factor analysis,the factor of the average cost of the three hospitals accounted for more than 80%of the total cost reduction,and the average hospitalization days were also the main factor for the reduction of hospitalization days.Conclusion:The reform of DRG payment significantly reduces fees and increases efficiency.Attention should be paid to the risk of cost transfer that may be brought about by the payment reform,and National Health Care Security Administration needs to increase supervision.At the same time,medical institutions must actively change thinking and behavior,and better adapt to the new situation of DRG reform.
作者
王奕婷
苑光波
WANG Yiting;YUAN Guangbo(Hu'nan University of Finance and Economics,Changsha,Hu'nan Province,410012,PRC)
出处
《中国医院》
北大核心
2022年第9期29-31,共3页
Chinese Hospitals
基金
湖南省自然科学基金(2020JJ5012)。
关键词
DRG
医保支付
因素分析法
例均费用
平均住院日
DRG
medical insurance payment
factor analysis
average cost
average hospital stay
