摘要
目的探讨在DRG支付下影响BR29病组患者住院医疗费用的主要支配因子,并对住院医疗各费用项目进行分类以提出分类控费建议。方法以新疆某三甲医院2022年7月1日-2023年6月30入组正常类型的549例BR29病组患者为例,将年龄、住院天数及住院医疗总费用的9个细分项目进行标准化后,分别使用因子分析法、聚类法对其进行降维处理及聚类分析验证。结果患者主要以男性、城镇居民、门诊入院患者为主,中位年龄为68岁,中位住院天数为9 d;影响住院医疗总费用的项目可以分为3大类,第一类为住院基础费用因子,第二类为住院诊疗过程费用因子,第三类为住院特殊费用因子。结论控制BR29病组住院医疗费用的过度增长,院方应着力控制住院天数、检查费、药品费、治疗费、化验费;医保部门应科学细化病组分组,完善支付标准的动态调整机制,科学实现“医、保、患”三方共赢。
Objective To explore the main dominant factors affecting the hospitalization medical expenses of patients with BR29 disease under DRG payment,and to classify the hospitalization medical expenses items to put forward suggestions for classified cost control.Methods From July 1,2022to June 30,2023,549 patients with normal type of BR29 disease were enrolled in a top three hospital in Xinjiang as an example.After standardizing the 9 sub-items of age,length of stay and total cost of hospitalization,the factor analysis method and clustering method were used to reduce the dimension and cluster analysis verification.Results The patients were mainly male,urban residents,and outpatients.The median age was 68 years old,and the median hospitalization days were 9 days.The items that affected the total cost of hospitalization could be divided into three categories,the first category was the basic cost factor of hospitalization,the second category was the cost factor of hospitalization diagnosis and treatment process,and the third category was the special cost factor of hospitalization.Conclusion In order to control the excessive growth of hospitalization medical expenses in BR29 disease group,the hospital should focus on controlling hospitalization days,inspection fees,drug fees,treatment fees,and laboratory fees;the medical insurance department should scientifically refine the group of disease components,improve the dynamic adjustment mechanism of payment standards,and scientifically achieve a win-win situation among doctors,insurance and patients.
作者
魏洁群
王小燕
谢玉婷
杨岩
徐敬轩
WEI Jiequn;WANG Xiaoyan;XIE Yuting;YANG Yan;XU Jingxuan(Department of Information and Equipment Management,the Second Affiliated Hospital of Xinjiang Medical University,Urumqi 830000,Xinjiang,China;the Second Department of Neurosurgical,the Second Affiliated Hospital of Xinjiang Medical University,Urumqi 830000,Xinjiang,China)
出处
《医学信息》
2025年第7期43-47,共5页
Journal of Medical Information
基金
新疆维吾尔自治区科技支疆项目(编号:2022E02060)。
