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Received:April 17, 2023 Published Online:November 20, 2023
Received:April 17, 2023 Published Online:November 20, 2023
中文摘要: 目的 分析疾病诊断相关分组(DRGs)政策对逆行胰胆管造影术(ERCP)患者住院费用的影响,为推广实施DRGs付费提供参考。方法 收集南京鼓楼医院2021年1月至2022年12月行ERCP患者的住院费用数据,共纳入617例患者,其中2021年1月至12月按项目付费组310例,2022年1月至12月按DRGs付费组307例。采用横断面研究方法,对比分析不同付费方式下行ERCP患者的住院费用及其影响因素。结果 按DRGs付费组患者住院费用低于按项目付费组,差异有统计学意义(18 640.1元 vs 24 528.7元,P<0.05)。按DRGs付费组患者卫生材料费、药品费、手术费、化验费、床位费和护理费低于按项目付费组,但检查费和诊查费高于按项目付费组,差异有统计学意义(P<0.05)。线性回归分析显示,卫生材料费、药品费、检查费、手术费、住院天数、DRGs分组和合并症是按DRGs付费组患者住院费用的独立影响因素(P<0.05)。结论 通过加强临床路径管理和病案首页书写等医院精细化管理,DRGs的实施有助于降低ERCP患者的住院费用和减轻患者的经济负担。
中文关键词: 内镜逆行胰胆管造影术 疾病诊断相关分组付费 住院费用 临床路径管理 精细化管理
Abstract:Objective To analyze the impact of diagnosis related groups (DRGs) policies on the hospitalization costs of patients undergoing endoscopic retrograde cholangiopancreatography (ERCP), and to provide reference for promoting the implementation of DRGs payment. Methods The hospitalization cost data of patients receiving ERCP in Nanjing Gulou Hospital from January 2021 to December 2022 were collected. A total of 617 patients were included, including 310 patients in the project-based payment group from January 2021 to December 2021 and 307 patients in the DRGs payment group from January 2022 to December 2022. A cross-sectional study was used to compare and analyze the hospitalization costs and influencing factors of ERCP patients under different payment methods. Results The average hospitalization costs of patients in the DRGs payment group were lower than those in the item-based payment group, and the difference was statistically significant (18 640.1 yuan vs 24 528.7 yuan, P<0.05). In the DRGs payment, the costs of healthcare materials, medications, surgery, laboratory tests, bed fees, and nursing were lower than those in the item-based payment group, while the costs of examinations and consultations were higher, and the differences were statistically significant (P<0.05). Logistic multivariate analysis showed that healthcare materials, medication costs, examination costs, surgery costs, length of hospital stay, DRGs grouping, and complications were independent influencing factors for hospitalization costs in the DRGs payment (P<0.05). Conclusion The implementation of DRGs can help reduce hospitalization costs for ERCP patients and alleviate their financial burden through measures such as strengthening clinical pathway management and documentation in hospital management.
keywords: Endoscopic retrograde cholangiopancreatography Diagnosis related groups payments Hospitalization costs Clinical pathway management Refined management
文章编号: 中图分类号: 文献标志码:B
基金项目:南京鼓楼医院2022年度立项护理科研课题(2022-A1388)
Author Name | Affiliation |
ZHAO Qin, YANG Hua, LI Nannan | Department of Gastroenterology,The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu 210008, China |
Author Name | Affiliation |
ZHAO Qin, YANG Hua, LI Nannan | Department of Gastroenterology,The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu 210008, China |
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