摘要
[目的]研究DIP改革对新生儿肺炎患儿住院费用的影响,为合理控费、深化医保改革提供依据。[方法]收集2021-2023年某三甲妇幼保健院新生儿肺炎病例相关信息,分为DIP改革前、改革后两组,运用χ2检验、Mann-Whitney U检验、新灰色关联和结构变动分析法进行数据分析。[结果]DIP改革后,新生儿肺炎患儿住院总费用降低14.47%,诊断费降低36.08%,药品费降低38.96%,耗材费降低22.94%,差异均具有统计学意义(P<0.001);改革前后,诊断费与住院费用关联度均最大,分别是0.8778和0.9274,但诊断费的构成比降低5.68%;改革前后医疗服务费、护理费和治疗费的VSV分别是1.04%、1.18%和10.67%,诊断费、药品费和耗材费的VSV分别是-3.88%、-8.93%和-0.13%。[结论]DIP改革降低了新生儿肺炎患儿的住院费用,诊断费是影响住院费用结构变动的主要因素,DIP改革在一定程度上优化了住院费用结构。
Objective To study the impact of DIP reform on hospitalization expenses of neonates with pneumonia,so as to provide a basis for reasonable cost control and deepening medical insurance reform.Methods The data of neonatal pneumonia in a tertiary grade-A maternal and child care hospital from 2021 to 2023 were collected and divided into two groups,before and after DIP reform.Data were analyzed by chi-square test,Mann-Whitney U test,new grey correlation and structural variation analysis method.Results After DIP reform,the total hospitalization cost of neonates with pneumonia was reduced by 14.47%;diagnostic cost decreased by 36.08%;drug cost decreased by 38.96%,and consumables cost decreased by 22.94%.The differences were statistically significant(P<0.001).Before and after the reform,the correlation between diagnostic cost and hospitalization cost was the highest,which was 0.8778 and 0.9274,respectively,but the component ratio of diagnostic cost decreased by 5.68%.Before and after DIP reform,VSV of medical service fee,nursing fee and treatment fee were 1.04%,1.18%and 10.67%,respectively;VSV of diagnostic fee,medicine fee and consumables fee were-3.88%,-8.93%and-0.13%,respectively.Conclusions The DIP reform reduces the hospitalization cost of neonates with pneumonia,and the diagnostic fee is the main factor affecting the structural change of hospitalization cost.The DIP reform optimizes the structure of hospitalization cost to some extent.
作者
郭亮
路晨琳
蒋重阳
张俊清
徐云飞
张倩
GUO Liang;LU Chenlin;JIANG Chongyang;ZHANG Junqing;XU Yunfei;ZHANG Qian(The Third Affiliated Hospital of Zhengzhou University,Zhengzhou Henan 450000,China)
出处
《卫生软科学》
2024年第7期1-4,共4页
Soft Science of Health
基金
2023年度河南省医学科技攻关计划项目-DRG/DIP医保付费改革背景下妇幼保健机构管理机制和服务模式探索(RKX202302019)
2022年度河南省医学科技攻关计划项目-DIP支付改革背景下临床路径在医院运营中的成本效果分析(LHGJ20220552)。
关键词
按病种分值付费
新生儿肺炎
住院费用
结构变动
Diagnosis-Intervention Packet
neonatal pneumonia
hospitalization cost
structure variation
