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[1]朱萍唐慧张静陈静夏开建叶宏伟.DRG支付方式改革下急性胰腺炎医疗费用结构分析：基于灰色—马尔科夫链预测模型[J].中国卫生质量管理,2025,32(09):66-72.[doi:10.13912/j.cnki.chqm.2025.32.9.13]
　ZHU Ping,TANG Hui,ZHANG Jing.Analysis of Medical Expense Structure for Acute Pancreatitis Under the Reform of DRG Payment System: Based on the Grey-Markov Chain Prediction Model[J].Chinese Health Quality Management,2025,32(09):66-72.[doi:10.13912/j.cnki.chqm.2025.32.9.13]

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DRG支付方式改革下急性胰腺炎医疗费用结构分析：基于灰色—马尔科夫链预测模型

《中国卫生质量管理》[ISSN:1006-7515/CN:CN 61-1283/R] 卷: 32 期数: 2025年09期页码: 66-72 栏目: 医疗质量出版日期: 2025-09-15

Title:: Analysis of Medical Expense Structure for Acute Pancreatitis Under the Reform of DRG Payment System: Based on the Grey-Markov Chain Prediction Model

作者:: 朱萍唐慧张静陈静夏开建叶宏伟; 苏州大学附属常熟医院

Author(s):: ZHU Ping; TANG Hui; ZHANG Jing; Changshu Hospital Affiliated to Soochow University

关键词:: 急性胰腺炎; DRG; 医疗费用; 灰色关联度分析; 灰色—马尔科夫链; 时间序列分析

Keywords:: Acute Pancreatitis; DRG; Medical Expenses; Grey Relational Analysis; Grey-Markov Chain; Time Series Analysis

分类号:: R197.323；R576

DOI:: 10.13912/j.cnki.chqm.2025.32.9.13

文献标志码:: A

摘要:: 目的探讨DRG支付方式改革下急性胰腺炎医疗费用结构特征及变化趋势，为医院控费与收入结构优化提供参考。方法收集2022年10月—2023年8月江苏省某三级医院496例急性胰腺炎（HT21/HT23/HT25组）患者数据，采用灰色关联分析筛选费用影响因素，构建灰色—马尔科夫链时间序列模型预测费用占比，并与GM(1,1)模型和ARIMA模型对比效能。结果不同DRG分组中医疗总费用、支付盈亏和价值收入存在显著差异（P<0.05）。灰色关联分析表明，检验费、药品费、西药费、检查费和医疗服务收入与医疗总费用关联度较高。灰色—马尔科夫链模型在预测费用占比方面表现优于GM（1，1）模型和ARIMA模型。结论急性胰腺炎的药占比呈下降趋势，而检查费和检验费有所上升。医院需优化收入结构，减少不必要的检查和检验。灰色—马尔科夫链模型为医院在DRG支付方式改革下加强内部运营管理和优化收入结构提供了参考。

Abstract:: ObjectiveTo explore the structural characteristics and changing trends of medical expenses for acute pancreatitis under the reform of diagnosis-related groups (DRG) payment methods, providing references for hospital cost control and revenue structure optimization. MethodsData from 496 patients with acute pancreatitis (grouped as HT21/HT23/HT25) admitted to a tertiary hospital in Jiangsu Province from October 2022 to August 2023 were collected. Grey relational analysis was used to screen influencing factors of expenses, and a grey-Markov chain time series model was constructed to predict expense proportions, with its performance compared to those of the GM(1,1) and ARIMA models. ResultsSignificant differences were observed in total medical expenses, payment surpluses/deficits, and value-based revenue among different DRG groups (P<0.05). Grey relational analysis indicated that examination fees, medication costs, western medicine fees, inspection fees, and medical service revenue were highly correlated with total medical expenses. The grey-Markov chain model outperformed the GM(1,1) and ARIMA models in predicting expense proportions.Conclusion The proportion of medication costs for acute pancreatitis showed a declining trend, while inspection and examination fees increased. Hospitals need to optimize their revenue structures and reduce unnecessary inspections and examinations. The grey-Markov chain model provides a reference for hospitals to strengthen internal operational management and optimize revenue structures under the DRG payment reform.

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更新日期/Last Update: 2025-09-15