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——曾跃萍 吕亚奇 田剑 张欣 王丽 刘颖 陈燕华 宋菲 刘帅
【摘要】目的探索新生儿DRGs分组PU11组的影响因素及分组调整的必要性。方法以北京某三甲儿童医院2016年-2018年PU11组新生儿住院病案记录作为研究对象，利用Spearman相关、Wilcoxon秩和检验、正交设计、计算变异系数等方法，分析住院首页中关键信息对住院总费用的影响。结果呼吸机使用情况对该组住院总费用有影响，提示PU11组目前分组条件不能准确反映该组人群医疗消耗的差异。结论新生儿作为特殊群体，其准确的DRGs分组直接关系医院的绩效考核以及国家卫生资源的科学投入，通过对影响因素的探索，认为对PU11组进行调整是必要的。
【关键词】疾病诊断相关分组;新生儿;治疗操作
中图分类号：R197.323文献标识码：B
Analysis on Influencing Factors for Total Expense of Diagnosis Related Groups (PU11) in Neonates/ZENG Yueping,LV Yaqi,TIAN Jian,et al.//Chinese Health Quality Management，2020,27(5):47-51
AbstractObjectiveTo explore the factors and necessity of partition for Diagnosis Related Groups (DRGs)PU11 group in neonates.MethodsMedical records of neonates and partitioned into PU11 group of DRGs for a major children's hospital in Beijing from 2016 year to 2018 year were enrolled as subjects. Spearman correlation, Wilcoxon rank sum test、orthogonal design and coefficient of variation were used to analyze the affections of key information in the home page of medical records on the total hospitalization expenses.ResultsThe use of ventilators had an influence on the total hospitalization costs of the group, suggesting that the current grouping conditions of PU11 group could not accurately reflect the differences in the medical consumption of the group.Conclusion As a special group, the accurate DRGs grouping of newborns is directly related to the performance assessment of hospitals and the scientific input of national health resources. Through the exploration of influencing factors, it is believed that it is necessary to adjust PU11 group.
Key wordsDiagnosis-Related Groups;Neonates;Treatment Operation
Firstauthor's addressBeijing Children's Hospital/Capital Medical University, National Center for Children's Health, Beijing, 100045, China
疾病诊断相关分组（Diagnosis Related Groups, DRGs）是利用病案首页信息，根据患者的诊断、病情程度、手术操作等治疗方式及并发症等因素将病案分为多组进行管理的体系［1］。DRGs的准确分组会影响患者费用和医院绩效等。在实际临床工作中，对DRGs系统进行论证调整，是确保其可持续的最好保证。目前国内外均有探索影响DRGs合理分组因素的研究，如德国Vogl等人就临终关怀DRGs组相关因素进行两个中心的横断面研究分析［2］。韩国Kim团队就有关腺样体扁桃体切除术的DRGs分组因素进行单中心研究探讨［3］。台湾Lai等人为更好地预测医疗成本同样进行DRGs分组调整探索［4］。北京市于2014年正式实施DRGs，期间经过各医院在实践中多次修订，得到进一步完善，并开展了各种应用探讨和论证［5-7］。
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