首页|基于DRG的结直肠肿瘤外科手术患者麻醉费用影响因素及标杆值分析

基于DRG的结直肠肿瘤外科手术患者麻醉费用影响因素及标杆值分析

扫码查看
目的 对《国家医疗保障疾病诊断相关分组(CHS-DRG)细分组方案(1.0版)》中GB25组麻醉费用的影响因素及标杆值进行分析,探讨外科手术病组控费策略.方法 分析样本医院152例GB25组病例信息.通过单因素分析和多因素逐步回归分析麻醉费用的影响因素,并根据GB25组的支付标准、全市平均水平等指标构建院内麻醉费用标杆值评价体系.结果 单因素分析结果显示,是否腹腔镜手术、手术时长、麻醉医生影响麻醉费用,差异有统计学意义(P<0.05);多因素逐步回归分析结果显示,手术时长、麻醉医生是影响麻醉费用的主要因素.当麻醉费用大于院内中位数时应予以预警,当麻醉费用小于全市平均水平时应予以奖励.结论 医院应注重规范诊疗流程,缩短手术时长,从而降低麻醉费用;同时应积极推进临床路径管理,建立完善的DRG内部考核机制.
DRG based Analysis of Influencing Factors and Benchmark Values of Anesthesia Costs for Colorectal Can-cer Surgical Patients
Objective To analyze the influencing factors and benchmark value of anesthesia cost in GB25 group in CHS-DRG Group Division Strategy(1.0),and explore the cost control strategy for surgical patients.Methods The data of 152 GB25 cases in sample hospitals were analyzed statistically.Through single factor analysis and multiple stepwise regression analysis,the influencing factors of anesthesia expenses were analyzed,and the evaluation system of hospital anesthesia expenses was built according to the payment standard of GB25 group and the average level of the city.Results Univariate analysis showed that there was significant difference in the influence of laparoscopic surgery or not,operation duration and anesthesiologist on anesthesia cost(P<0.05);Stepwise regression further analysis showed that the length of operation and the anesthesiologist were the main influencing factors of anesthesia costs.Early warning shall be given when the anesthetic cost is greater than the median in the hospital,and rewards shall be given when the anesthetic cost is less than the average level in the city.Conclusion Hospitals should pay attention to standardize the diagnosis and treatment process,shorten the operation time,and reduce the anesthesia cost.At the same time,they should actively promote the clinical pathway management,and establish and improve the internal assessment mechanism of DRG.

anesthesia expensesDRGinfluencing factorsbenchmark value

张丽成、高明、冷家骅

展开 >

北京大学肿瘤医院暨北京市肿瘤防治研究所·恶性肿瘤发病机制及转化研究教育部重点实验室 北京 100142

麻醉费用 疾病诊断相关分组 影响因素 标杆值

2024

中国医院管理
中国医院管理杂志社

中国医院管理

CSTPCD北大核心
影响因子:2.15
ISSN:1001-5329
年,卷(期):2024.44(2)
  • 9