摘要
目的:比较DRG支付方式改革前后患者费用的差异,为浙江省医保支付制度改革提供依据。方法:收集浙江省某肿瘤医院头颈外科患者住院病案首页信息,采用t检验、Spearman相关性分析、Kruskal-Wallis H检验等方法,比较DRG改革前后患者住院费用及其构成的变化。结果:DRG改革后,头颈外科病组患者住院费用、药品费用、手术费用、护理费用、治疗费用、检查费用及住院天数都呈下降趋势(P<0.05),不同职称医疗组耗材费用差异具有统计学意义(P<0.05)。结论:DRG改革初现成效,但需与配套政策协同推进;建立医疗机构卫生技术评估机制,搭建术式套包,进一步管控医疗成本,降低患者住院费用。
Objective To compare the difference in patient expenses before and after the DRG payment method reform,so as to provide a basis for the reform of medical insurance payment system in Zhejiang Province.Methods The first page information of hospitalized medical records of head and neck surgery patients was collected in a Zhejiang tumor hospital.T test,Spearman correlation analysis and Kruskal-Wallis H test were used to compare the changes of hospitalization expenses and composition before and after DRG reform.Results After the DRG reform,the hospitalization expenses,drug expenses,operation expenses,nursing expenses,treatment expenses,examination expenses and hospitalization days of head and neck surgery patients group showed a downward trend(P<0.05),and the expense of consumables in different professional titles medical groups was statistically significant(P<0.05).Conclusion The DRG reform has achieved initial results,but it needs to be coordinated with supporting policies;establish a health technology evaluation mechanism for medical institutions,build surgical packages,further control medical costs,and reduce patient hospitalization expenses.
作者
赵跃
姚东
虞丽娟
林振威
吴风琴
俞新燕
ZHAO Yue;YAO Dong;YU Li-juan;LIN Zhen-wei;WU Feng-qin;YU Xin-yan(The Cancer Hospital of the University of Chinese Academy of Sciences(Zhejiang Cancer Hospital),Institute of Basic Medicine and Cancer,Chinese Academy of Sciences,Hangzhou Zhejiang 310022,China)
基金
2022年浙江省卫生健康科技计划“基于DRGs智能术式套包管理模式构建及优化研究”(2022RC117)。
关键词
DRG
头颈外科患者
费用结构
医疗费用控制
DRG
head and neck surgery patients
expense structure
medical expense control
