Analysis of Cost Structure and Related Influencing Factors of High Rate DRG Cases
Objective To analyze the cost structure of cases with high rate of DRG,study the related factors affecting the hospitalization cost,and rationally use the evaluation index of DRG,so as to provide reference for the fine management and high-quality development of public hospitals.Methods A top-three hospital in Guangxi was taken as a sample to describe and analyze the characteristics of high-rate cases,and SPSS 26.0 was used to analyze the influence of various factors on the cost.Results The data source was the DRG final trial data from January 2021 to June 2022 selected from the medical insurance platform.There were 6 217 cases with high rate,accounting for 5.76%.There was no significant difference in the proportion of high rate cases between the medical group and the surgical group(P>0.05).In the univariate analysis,the weight and department category had significant effects on the hospitalization cost of high rate cases(P<0.05),but the medical insurance category had no correlation with high rate costs(P>0.05).Conclusion It is relatively scientific and reasonable to formulate the identification criteria for high-rate cases by means of increasing weight and decreasing cost multiple,but at the same time,we should strengthen the review of illegal enrollment cases,pay attention to the problems existing in the current actual payment stage,change the traditional concept of payment by project,combine multiple payment methods,and rationally use DRG evaluation indicators to better adapt to the reform of DRG payment methods.
万方数据
维普
