首页|儿童阑尾切除术病组服务效率及费用结构的间断时间序列研究

儿童阑尾切除术病组服务效率及费用结构的间断时间序列研究

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目的:分析儿童专科医疗机构GD19(伴穿孔、化脓、坏疽等阑尾切除术)组和GD29(阑尾切除术)组在实施多学科会诊前后,服务效率和费用结构的变化.方法:收集2021—2022年样本医院北京市医保患者GD19组和GD29组病例数据,采用Mann-Whitney U检验分析医疗费用和效率指标的变化,并建立间断时间序列模型分析变化趋势.结果:与2021 年相比,2022年GD19组次均住院费用降低2 462.00元,GD29组降低2 042.60元(P<0.05),其中药品费、耗材费、检查检验费和治疗费均有下降.管理措施实施当月GD19组次均耗材费降低920.00元(P<0.05),GD29组次均耗材费降低632.50元.GD29组平均住院日由3.74天降低到2.78天(P<0.05).结论:管理措施实施后,GD19组和GD29组药品耗材成本得到控制,费用水平降低,运行效率提高.建议坚持重点DRG组遴选和多学科会诊的管理措施,调动临床科室管理积极性,加强儿科DRG分组和付费方案的论证和优化.
Interrupted Time Series Study on the Service Efficiency and Cost Structure of Appendectomy in Children
Objective:To analyze the changes in service efficiency and cost structure before and after implementing multidisci-plinary treatment in the GD19(appendectomy with perforation,suppuration,gangrene,etc.)and GD29(appendectomy)groups of pedi-atric specialty medical institutions.Methods:The case data of GD19 and GD29 groups of medical insurance patients in sample hospi-tals in Beijing from 2021 to 2022 were collected.Mann Whitney U test was used to analyze the changes of medical expenses and effi-ciency indicators,and intermittent time series model was established to analyze the change trend.Results:Compared to 2021,the av-erage hospitalization expenses of GD19 group in 2022 decreased by 2 462.00 yuan year-on-year,and that of GD29 group decreased by 2 042.60 yuan year-on-year(P<0.05).Among them,the cost of medicines,consumables,examinations and tests and treatment have all decreased.In the month when the management measures were implemented,the average consumption cost of GD19 group de-creased by 920.00 yuan(P<0.05),and the average consumption cost of GD29 group decreased by 632.50 yuan.The average length of stay in GD29 group decreased from 3.74 days to 2.78 days(P<0.05).Conclusion:After the implementation of management mea-sures,the cost of drug consumables in GD19 group and GD29 group was controlled,the cost level was reduced,and the operation effi-ciency was improved.It is suggested to adhere to the management measures of selection of key DRG groups and multidisciplinary con-sultation,mobilize the management enthusiasm of clinical departments,and strengthen the demonstration and optimization of pediatric DRG grouping and payment scheme.

Diagnosis Related Grouppediatricsappendectomymulti-disciplinary treatment

那春霞、王东子、刘之蕙、高广颖

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首都医科大学公共卫生学院 北京 100069

国家儿童医学中心(北京)首都医科大学附属北京儿童医院医保办 北京 100045

疾病诊断相关分组 儿科 阑尾切除术 多学科会诊

首都医科大学医院管理研究所2021年度开放性课题

2021YGS03

2024

中国卫生经济
中国卫生经济学会,卫生部卫生经济研究所

中国卫生经济

CSTPCDCHSSCD北大核心
影响因子:1.524
ISSN:1003-0743
年,卷(期):2024.43(2)
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