DRG支付政策实施前后患者住院费用比较分析.pdfVIP

DRG支付政策实施前后患者住院费用比较分析

Comparative Analysis of Hospitalization Expenses of Patients before 

and after Implementation of DRG Payment Policy

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□吕晓峰LVXiao-feng李园园LIYuan-yuan卞月梅BIANYue-mei游群芳YOUQun-fang张红ZHANGHong

摘要Abstract

目的分析DRG支付方式实施前后住院患者费用情况，为DRG支付方式的推进提供实证依据。方法以浙江

省卫健委发布的DRG为分组标准，选取2018年至2021年医院病案首页数据，形成基础DRG数据。运用卡方检验、

非参数秩和Mann-WhitneyU检验、Wilcoxon检验进行数据差异性统计，比较分析DRG支付方式实施前后住院患

者及住院费用情况。结果DRG支付方式实施后，DRG组数增加，CMI值上升，RW值分布结构更加优化，治愈/

好转率提高，15天和31天再入院率下降，时间消耗指数基本持平，费用消耗指数上涨；住院费用总量下降，药费、

耗材费、自付费用占比下降明显，医疗服务费、护理费有所提升，检查检验费略有上涨。结论DRG支付方式实施后，

医院整体运行平稳，整体医疗费用控制良好，住院费用结构日趋优化，但需进一步关注检查检验费用，防止住院

费用“内部转移”现象发生。

ObjectiveToanalyzetheexpensesofinpatientsbeforeandaftertheimplementationofDRGpaymentpolicy,andto

provideempiricalevidenceforthepromotionofDRGpayment.MethodsUsingDRGpublishedbyHealthCommissionof

ZhejiangProvinceasgroupingstandard,thefirstpagedataofhospitalmedicalrecordsfrom2018to2021wereselected

toformbasicDRGdata.Chi-squaretest,nonparametricrankandMann-WhitneyUtestandWilcoxontestwereusedfor

datadifferencestatistics.TheinpatientsandhospitalizationexpensesbeforeandaftertheimplementationofDRGpayment

policywerecomparedandanalyzed.ResultsAftertheimplementationofDRGpaymentpolicy,thenumberofDRGgroups

andtheCMIvalueincreased.ThedistributionstructureofRWvaluewasmoreoptimized,thecure/recoveryrateincreased.

Thereadmissionratedecreasedafter15daysand31days.Thetimeconsumptionindexwasbasicallythesame,andthe

costconsumptionindexincreased.Thetotalhospitalizationexpensesdecreased.Theproportionofmedicineexpens