摘要
目的研究按疾病诊断相关分组(diagnosis related groups,DRGs)付费实施对血液病患者住院费用的影响,为医院进行医保精细化管理提供决策依据。方法从天津市某三甲医院医院信息系统(hospital information system,HIS)中选取2021年10月—2022年3月和2022年10月—2023年3月共21448例患者的病历资料,经过倾向得分匹配法进行匹配,筛选出8134例血液病患者,再利用双重差分法分析DRG付费对血液病患者住院费用的影响。结果实施DRGs付费后,血液病患者的检查费的中位数从6306.50元降至5038.50元,自付费用中位数从7607.17元降至6562.08元,材料费的中位数从305.70元降至286.88元。本研究进一步通过DID分析消除潜在混杂因素的影响,发现自付费用仍下降(P<0.05)。结论DRGs控费初见成效,有效降低了血液病患者的个人负担,医院应持续关注DRGs的长期效果。
Objective To analyze the effect of the implementation of diagnosis-related groups(DRGs)on hospitalization cost of hematology patients,and provide the decision basis for hospitals and departments to carry out fine cost management.Methods A total of 21448 patients were selected from the hospital information system(HIS)of a ClassⅢhospital in Tianjin from October 2021 to March 2022 and from October 2022 to March 2023.After matching using propensity scoring matching method,8134 patients with hematological diseases were selected.Then the impact of DRGs payment on hospitalization expenses of hematological patients was analyzed using difference in difference method.Results After implementing DRGs payment,the median examination fee for hematology patients decreased from 6306.50 yuan to 5038.50 yuan,the median self expense decreased from 7607.17 yuan to 6562.08 yuan,and the median material cost decreased from 305.70 yuan to 286.88 yuan.This study further eliminated the impact of potential confounding factors through DID analysis,and found that self-supporting expenses still significantly decreased(P<0.05).Conclusion The cost control effect of DRGs is beginning to show,reducing the individual burden of hematology patients.Hospitals should continue to pay attention to the long-term effect of DRGs policy.
作者
陈楚涵
张萧红
王宏
杨翼帆
段剑飞
苏丽华
CHEN Chuhan;ZHANG Xiaohong;WANG Hong;YANG Yifan;DUAN Jianfei;SU Lihua(Department of Medical Insurance and Price,State Key Laboratory of Experimental Hematology,National Clinical Research Center for Blood Diseases,Haihe Laboratory of Cell Ecosystem,Institute of Hematology/Blood Diseases Hospital,Chinese Academy of Medical Sciences/Peking Union Medical College,Tianjin 300020,China;Tianjin Institutes of Health Science,Tianjin 301600,China)
出处
《中国卫生标准管理》
2024年第17期74-79,共6页
China Health Standard Management
关键词
疾病诊断相关分组
住院费用
双重差分法
倾向得分匹配
血液病
医保
diagnosis related groups
hospitalization costs
difference in difference
propensity scoring matching
hemopathy
medical insurance
