[1]唐佳骥 宋磊 张彤彦 许欣悦 陈伟岗.北京某院DRGs收付费模拟运行效果评价[J].中国卫生质量管理,2020,27(03):047-50.
　ANG Jiaji,SONG Lei,ZHANG Tongyan,et al.Evaluation of DRGs Charging and Payment Simulation Operation Effect in A Hospital in Beijing[J].Chinese Health Quality Management,2020,27(03):047-50.
点击复制

北京某院DRGs收付费模拟运行效果评价
分享到：

《中国卫生质量管理》[ISSN:1006-7515/CN:CN 61-1283/R]

卷:
第27卷
期数:
2020年03期
页码:
047-50
栏目:
关注DRG
出版日期:
2020-05-28

文章信息/Info

Title:
Evaluation of DRGs Charging and Payment Simulation Operation Effect in A Hospital in Beijing
作者:
唐佳骥 宋磊 张彤彦 许欣悦 陈伟岗
首都医科大学附属北京同仁医院
Author(s):
ANG Jiaji; SONG Lei; ZHANG Tongyan; et al
Beijing Tongren Hospital, Capital Medical University
关键词:
DRGs; 收付费; 效果评价
Keywords:
DRGs; Charging and Payment;  Effect Evaluation
分类号:
R197.323；R197.5
文献标志码:
B
摘要:
目的以TR医院为例，评估北京市DRGs收付费政策模拟运行两个月的效果。方法通过一个准实验方案，以模拟运行为控制因素，收集2017年12月-2018年1月（模拟运行前）和2018年12月-2019年1月（模拟运行后）时间段的相关医疗指标，从病组变化、服务能力、服务效率和医疗质量四个层面结合相关统计学方法进行前后侧对比。结果重点学科覆盖病组数改革后增加了7个（P<0.05），但全院总体病组数无变化；服务量和诊疗难度有所提升；平均住院日等多个效率指标较改革前均有显著改善（P<0.05）；医疗质量指标较改革前无统计学差异（P>0.05）。结论目前，DRGs收付费在该院的模拟运行效果主要体现在服务能力和效率上，刺激相关流程的改善，同时保证了医疗质量，但控费效果不显著。建议在充分论证的基础上，正式推行DRGs收付费改革，关注结算等待时间的影响、病理医师人力资源配备、政策间衔接等问题。远期来看，DRGs收付费改革可发挥多方面积极作用，有助于保障群众基本医疗权益和医保制度长期可持续发展。
Abstract:
ObjectiveTaking TR hospital as an example, the study evaluated and analyzed the effect of the simulated operation of DRGs charging and payment policy in Beijing for two months.MethodsThrough a quasi-experimental program and taking simulation operation as the control factor, relevant medical indicators in the period of December 2017 to January 2018 (before the simulation) and December 2018 to January 2019 (after the simulation) were collected, and the before-after comparison was made from the perspectives of disease group changes, service ability,service efficiency and medical quality by combining relevant statistical methods.ResultsThe number of key clinical subject coverage groups increased by 7 (P<0.05), but the total number of disease groups in the hospital did not change; the service volume and the difficulty of diagnosis and treatment increased; the average length of stay and other efficiency indicators were significantly improved than those before the reform (P<0.05); and there was no statistical difference on the medical quality indicators (P>0.05). Conclusion At present, the effect of DRGs charging and paying simulation operation in the hospital was mainly reflected in the service capacity and efficiency, which stimulated the improvement of related processes and guaranteed the medical quality, but the effect of cost control was not significant. It was suggested that, on the basis of full demonstration, the DRGs charging and payment reform should be formally implemented, with a focus on the impact of settlement waiting time, pathologist human resource allocation, and policy convergence,etc.In the long run, DRGs charging and payment reform can play a positive role in many aspects, and help protect the basic medical rights and interests of the general public and the long-term sustainable development of the medical insurance system.

参考文献/References:

［1］中共中央 国务院.中共中央国务院关于深化医药卫生体制改革的意见［EB/OL］. （2019-04-08）.http://www.gov.cn/test/2009-04/08/content_1280069.htm.

相似文献/References:

[1]杨山石 何梅 汤洁 金春林 王贤吉.基于DRGs的上海嘉定医疗服务质量与绩效评价研究[J].中国卫生质量管理,2017,24(03):022.[doi:10.13912/j.cnki.chqm.2017.24.3.08]
[2]罗爱静 阎雪彬 戴萍萍 刘杰荣 常维夫.湖南地区某院耳鼻咽喉科医疗绩效分析[J].中国卫生质量管理,2017,24(03):029.[doi:10.13912/j.cnki.chqm.2017.24.3.10]
[3]吴琦 李亚伟 段智慧.学科内分组法在临床路径管理中的应用[J].中国卫生质量管理,2018,25(01):031.[doi:10.13912/j.cnki.chqm.2018.25.1.11]
[4]舒琴 李迪 胡靖琛 孙扬 肖涟 徐小兵 周蕾 钟勇 金律.DRGs评价医院绩效的SWOT分析[J].中国卫生质量管理,2018,25(02):005.[doi:10.13912/j.cnki.chqm.2018.25.2.02]
[5]胡靖琛 程羿嘉 朱士杰.应用DRGs助力医院学科建设[J].中国卫生质量管理,2018,25(05):028.[doi:10.13912/j.cnki.chqm.2018.25.5.09]
[6]张丽敏 杨建玲 王丽君 王海明 王瑭鹃.基于DRGs的病案首页质量分析[J].中国卫生质量管理,2019,26(01):033.[doi:10.13912/j.cnki.chqm.2019.26.1.11]
[7]杨宏伟 边维娜 丁涛 吕增发.DRGs在汉中市综合医院医疗质量评价中的应用[J].中国卫生质量管理,2019,26(01):036.[doi:10.13912/j.cnki.chqm.2019.26.1.12]
[8]陈颖 王峰 孔晴宇 佟朝霞 周艳军 陈宇 魏永祥.医改政策对医院住院费用的影响分析[J].中国卫生质量管理,2019,26(03):030.[doi:10.13912/j.cnki.chqm.2019.26.3.08]
[9]胡靖琛 程羿嘉 李煜 刘明孝 朱士杰.基于DRGs的眼科住院医疗服务绩效分析[J].中国卫生质量管理,2019,26(04):020.[doi:10.13912/j.cnki.chqm.2019.26.4.06]
[10]殷希.基于文献计量分析的我国DRGs研究现状[J].中国卫生质量管理,2019,26(05):049.[doi:10.13912/j.cnki.chqm.2019.26.5.15]

更新日期/Last Update: 2020-05-28