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[1]许敏刘娇宁杰夏雪邱晶青丁小倩.基于结构方程模型的肿瘤专科医院DIP高费用病例特征分析[J].中国卫生质量管理,2026,33(6):48-52.[doi:10.13912/j.cnki.chqm.2026.33.6.10]
　XU Min,LIU Jiao,NING Jie.Analysis of Characteristics of DIP High-Cost Cases in Oncology Specialist Hospitals Based on Structural Equation Modeling[J].Chinese Health Quality Management,2026,33(6):48-52.[doi:10.13912/j.cnki.chqm.2026.33.6.10]

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基于结构方程模型的肿瘤专科医院DIP高费用病例特征分析

《中国卫生质量管理》[ISSN:1006-7515/CN:CN 61-1283/R] 卷: 33 期数: 2026年6期页码: 48-52 栏目: 医疗质量出版日期: 2026-06-15

Title:: Analysis of Characteristics of DIP High-Cost Cases in Oncology Specialist Hospitals Based on Structural Equation Modeling

作者:: 许敏刘娇宁杰夏雪邱晶青丁小倩; 中山大学肿瘤防治中心/华南恶性肿瘤防治全国重点实验室

Author(s):: XU Min; LIU Jiao; NING Jie; Sun Yat-sen University Cancer Center/State Key Laboratory of Oncology in South China

关键词:: DIP; 高费用病例; 肿瘤; 结构方程模型; 医疗质量

Keywords:: DIP; High-Cost Cases; Oncology; Structural Equation Modeling; Medical Quality

分类号:: R197.5；R73

DOI:: 10.13912/j.cnki.chqm.2026.33.6.10

文献标志码:: A

摘要:: 目的分析广州市某三甲肿瘤专科医院按病种分值付费(DIP)高费用病例特征，并对医保政策制订及医院管理提出优化建议。方法计算案例医院2024年度所有高费用病例的DIP支付差额，采用单因素分析和结构方程模型，分析高费用病例DIP支付差额的影响因素及其相互关系。结果DIP高费用病例以治疗费（29.87%）占比最高，其次是药品费（27.47%）。各变量对高费用病例DIP支付差额影响因素从大到小依次是手术级别、是否发生院感、险种类型、住院天数、合并症、并发症数量、年龄。结论现行DIP政策在体现手术病种和合并症并发症的资源消耗上仍存在不足。DIP模式下，医疗机构应升级医院感染防控策略，建立院内高费用病例分级评审体系，优化工作流程，合理管控住院天数，建立完善的高费用病例评审机制。

Abstract:: ObjectiveTo analyze the characteristics of high-cost cases of DIP in a tertiary-level oncology specialist hospital in Guangzhou and provide toptimization suggestions for medical insurance policy formulation and hospital management.?倓MethodsThe DIP payment discrepancies for all high-cost cases in the case hospital in 2024 were calculated. Univariate analysis and structural equation modeling were employed to analyze the influencing factors of DIP payment discrepancies in high-cost cases and their interrelationships.ResultsAmong high-cost DIP cases, treatment expenses accounted for the highest proportion (29.87%), followed by drug expenses (27.47%). The factors influencing DIP payment discrepancies in high-cost cases, ranked from largest to smallest impact, were surgical grade, occurrence of nosocomial infections, insurance type, length of hospital stay, number of comorbidities and complications, and age.Conclusion The current DIP policy still has deficiencies in reflecting the resource consumption associated with surgical conditions and comorbidities/complications. Under the DIP model, medical institutions should upgrade nosocomial infection prevention and control strategies, establish a hierarchical review system for high-cost cases within the hospital, optimize workflows, reasonably manage the length of hospital stays, and establish a comprehensive review mechanism for high-cost cases.

参考文献/References:

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更新日期/Last Update: 2026-06-15