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某三甲中医医院DRG付费实施效果评价

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目的 评估按DRG付费对某三甲中医医院单病种住院费用的影响。方法 以某三甲中医医院2020年1月-2021年12月心内科DRG病组为FM19(经皮冠状动脉支架植入术)的患者住院信息为研究对象,利用Stata15统计软件、运用中断时间序列模型、双重差分法等评估该病组按DRG付费前后的费用变化趋势。结果 按DRGs付费实施后,FM19病组年平均总费用下降了 26 503。62元(P<0。001),年平均耗材费用下降了 23 937。32元(P<0。001)。FM19病组整体中医中药费用显著下降(P<0。05)。心绞痛患者的总费用、耗材费和药品费整体呈下降趋势;心肌梗死患者的药品费用减少不明显,总费用和耗材费下降显著。结论 某病种开展按DRG付费后控费效果显著,中医中药治疗费用下降明显。三甲中医医院需提早布局,应对和适应付费改革。
Evaluation of the implementation effects of DRG-based payment for a single disease in a tertiary tradi-tional Chinese medicine hospital
Objective To assess the impact of DRG-based payment on inpatient costs for a single disease in a tertiary traditional Chinese medicine hospital.Methods This study focused on the inpatient information of patients with the DRG group FM19(percutaneous coronary artery stenting)in the cardiology department of a tertiary traditional Chinese medicine hospital from January 2020 to December 2021.We utilized Stata 15 statistical software and applied interrupted time series models and differ-ence-in-differences methods to evaluate the cost changes before and after DRG-based payment.Results After the implementa-tion of DRG-based payment,the annual average total cost for the FM19 group decreased by 26 503.62 yuan(P<0.001),and the annual average cost of consumables decreased by 23 937.32 yuan(P<0.001).The overall costs of traditional Chinese medi-cine and herbal treatments in the FM19 group significantly decreased(P<0.05).For patients with angina,total costs,consum-able costs,and medication costs showed an overall decreasing trend;however,for patients with myocardial infarction,the reduc-tion in medication costs was not significant,while total costs and consumable costs decreased significantly.Conclusion The im-plementation of DRG-based payment for this disease type has shown significant cost control effects,with a notable decrease in the costs of traditional Chinese medicine treatments.Tertiary traditional Chinese medicine hospitals should proactively prepare to re-spond to and adapt to payment reforms.

Tertiary traditional chinese medicine hospitalDisease diagnosis related groupsPayment effects

陈柯羽、戚淼杰、刘中勋

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首都医科大学附属北京中医医院 北京 100010

三甲中医医院 疾病诊断相关分组 付费效果

2024

现代医院
广东省医院协会

现代医院

影响因子:1.332
ISSN:1671-332X
年,卷(期):2024.24(10)