The impact of DRG payment based on structural variation degree and grey correlation on hospitalization expenses of gynecological tumor inpatients
Objective To explore the main categories and changing directions of hospitalization expenses of gynecological tumors,and provide strategies and suggestions for effectively controlling hospitalization expenses and improving the payment scheme of medical insurance fund.Methods The expense information of patients discharged from Huzhou Central Hospital from January 2020 to December 2022 was collected,and analyzed by the payment method of structural variation and disease diagnosis related groups(DRG)with grey correlation,and the correlation degree was observed.Results From 2020 to 2022,the average hospitalization cost of 2 138 gynecological tumor patients showed a downward trend.The hospitalization cost structure of patients showed that surgical and laboratory expenses accounted for a relatively high proportion,while nursing and treatment expenses accounted for a relatively low proportion.The changes in the hospitalization structure of patients showed that material costs were gradually decreasing,while operating costs,bed fees,pathology fees,and nursing fees were gradually increasing.Diagnosis and treatment fees,drug fees,radiation fees,testing fees,treatment fees,surgery fees,and other expenses were first decreasing and then increasing.In the hospitalization expenses of gynecological tumors from 2020 to 2022,the most closely related expenses were surgical expenses,drug expenses,and laboratory expenses,while the least related expenses were bed expenses,nursing expenses,and treatment expenses.The proportion of patient hospitalization expenses was basically consistent with the degree of correlation.The structural change rate of hospitalization expenses for gynecological tumors from 2020 to 2022 was 13.67％,with a structural change rate of 14.61％from 2020 to 2021 and 10.77％from 2021 to 2022.The direction of structural changes showed that from 2020 to 2022,there were positive changes in operating fees,bed fees,pathology fees,and nursing fees,with significant changes in surgical fees.The largest contribution rate of changes in the hospitalization cost structure of gynecological tumors from 2020 to 2022 was surgical expenses,accounting for 37.29％,followed by examination expenses,accounting for 13.08％.The contribution rates of various expenses to the structural changes of average hospitalization expenses varied during different time periods.From 2020 to 2021,the largest contribution rate of hospitalization expense structural changes was surgical expenses,accounting for 33.05％,followed by drug expenses,accounting for 12.05％.From 2021 to 2022,the largest contribution rate of hospitalization expense structural changes was surgical expenses,accounting for 48.00％,followed by drug expenses,accounting for 16.85％.Correlation analysis showed that the hospitalization expenses of patients were related to medical insurance type and length of stay(P＜0.05).Conclusion The average hospitalization cost of gynecological tumor patients has been effectively controlled,and their clinical hospitalization costs are gradually rationalized.However,material and surgical costs still have a significant impact on the hospitalization costs of patients,indicating that the labor value of clinical medical personnel has increased less.DRG payment can control clinical medical expenses to a certain extent,and further optimization is needed to improve supporting policies,enhance the technical value of medical personnel,and strengthen the management of medical consumables.
Gynecological tumorsStructural variationGrouping by disease diagnosis related groupsGrey correlationHospitalization expenses
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万方数据
