Influence of different surgical methods on hospitalization days and hospitalization costs and GB1 group optimization suggestions
Objective To analyze the influence of different surgical methods on hospitalization days and hospitalization costs in the same group using the China healthcare security diagnosis related groups(CHS-DRG),and to provide reasonable suggestions for adjusting the major esophagus,gastric,and duodenal surgery.Methods The medical record homepage information and hospitalization costs information of patients in GB1(the major esophageal,gastric,and duodenal surgery)group in Cancer Hospital,Chinese Academy of Medical Sciences were extracted from January 2018 to December 2023 from the Beijing Regional Inpatient Medical Service Performance Evaluation Platform,including 9 148 cases in the"major esop-hageal,gastric,and duodenal surgery without serious com-plications or comorbidities"(GB15)group and 584 cases in the"major esophageal,gastric surgery with serious complications or comorbidities"(GB11)group.Using age and sex as confounding factors,the confounding factors of age and sex were evenly distributed among different surgical methods by inverse probability weighting method,the hospitalization days and hospitalization costs of different surgical methods adjusted by GB11 and GB15 groups were compared.Results After GB11 group adjustment,There were significant differences in hospitalization days,total hospitalization cost,medical cost,nursing cost,medical technology cost,administrative cost,and drug cost of patients with different surgical methods(P＜0.05).After GB15 group adjustment,there were significant differences in hospitalization days,total hospitalization cost,medical cost,nursing cost,medical technology cost,administrative cost,consumables cost,and drug cost of patients with different surgical methods(P＜0.05).Conclusion Combined with the difference of hospitalization days of patients with different surgical methods,the inclusion criteria were adjusted,and the surgical difficulty coefficient was added as the group dimension to avoid large differences in resource consumption within the group.At the same time,the special case exclusion mechanism is established as an effective supplement to DRG to reasonably fulfill the value of clinical services.In the process of upgrading and adjusting the DRG group scheme,GB1 group is divided into three ADRG groups,namely major esophagus surgical,major stomach surgical,and major pancreas and duodenum surgical,so that the resource consumption and surgical difficulty matched the group,improve clinical enthusiasm,and also coincide with the trend of dynamic adjustment of DRG and gradual refinement of the scheme.Furthermore,medical institutions can achieve cost reductions by implementing a disease-specific assessment system for drug and consumable costs,alongside utilizing national centralized procurement strategies for drugs and consumables.These measures can effectively control expenses related to medications and supplies,thereby lowering medical costs and enhancing overall medical efficiency.
Disease diagnosis related groupsMajor esophageal surgeryPancreaticoduodenectomyHospitalization daysHospitalization costs
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