目的 分析疾病诊断相关分组付费(diagnosis related groupprospective payment system,DRG-PPS)对检验科检测项目的影响.方法 统计DRG付费实施前后医院和病房4个代表科室生化人均检测项目数和人均检测费用的变化,并分析相关影响因素.结果 DRG付费实施后,病房常规、病房急查生化人均检测项目数和人均检测费用大幅下降(P＜0.05);门诊生化人均检测项目数下降(P＜0.05),人均检测费用增长(P＜0.05);门诊急诊生化人均检测项目数略增长(P＞0.05),人均检测费用小幅增长(P＜0.05);病房4个代表科室常规生化两项数据大幅下降(P＜0.05),急诊检查生化各科室增降不同;急诊样本量增加科室两项数据大幅下降(P＜0.05),急诊样本量变化不大的科室两项数据变化不大(P＞0.05).结论 DRG付费对检验科的工作量和工作模式产生影响,检验科应在当前模式上做出调整,适应DRG付费诊疗模式带来的变化.
An Analysis of the Influence of DRG Prospective Payment System on Biochemical Test Items in a Hospital in Beijing
Objective To analyze the influence of Diagnosis Related Group Prospective Payment System(DRG-PPS)on the quantity of testing items.Methods The changes of biochemical per capita test items and per capita test expenses in the hospital and representative departments of four wards before and after the implementation of Diagnosis Related Group Prospective Payment System(DRG-PPS)were counted,and the related influence factors were further analyzed.Results After the implementation of DRG-PPS,the number of biochemical tests per capita and the cost per capita decreased significantly(P＜0.05).The number of biochemical tests per capita decreased(P＜0.05),while the cost per capita increased(P＜0.05).The number of emergency biochemical tests per capita increased slightly(P＞0.05),and the cost per capita increased slightly(P＜0.05).The two key measurements of routine biochemistry in representative departments of four wards decreased significantly(P＜0.05),while the increase and decrease patterns of biochemical departments in emergency investigation were different:The two data of departments in emergency investigation increased significantly(P＜0.05),while the two key measurements of departments in emergency investigation did not show significant changes(P＞0.05).Conclusion DRG-PPS has an impact on the workload and working mode of the clinical laboratory,and the clinical laboratory should apply adjustments in the current mode to adapt the changes brought about by DRG-PPS and treatment mode.
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