Study on the cost adjustment model for patients of different age groups under the diagnosis-related group prospective payment system
Objective To explore the cost adjustment model based on age coefficient and to make the payment standard more consistent with the actual resource consumption in clinical settings partially address the issue of targeting elderly patients that may arise after the implementation of DRG-PPS payment.Methods The study analyzed data from all discharged patients in a hospital in 2022.Case rate coefficients were calculated for different age groups(young-middle-aged group,early elderly group,and high-aged elderly group)using the DRG(Diagnosis-related Group)rate formula to adjust the payment standard.The statistical significance of the difference between the actual cost and the current payment standard(within-group difference)was determined using the paired t-test in SPSS software.The Wilcoxon rank sum test was then used to determine the statistical significance of the difference between the actual cost and the adjusted payment standard(between-group difference).To assess the applicability of the age coefficient adjustment model,11 disease groups were selected,and the Wilcoxon rank sum test was used to determine if there was a statistical difference between the adjusted and non-adjusted groups.The effectiveness of the adjustment was judged based on the standard deviation.Results There was no significant difference between the actual hospitalization costs and the current standards(Group 1)and the actual hospitalization costs and the adjusted payment standards(Group 2)(P values were 0.928 and 0.949,both greater than or equal to 0.05).The results of the rank sum test showed a statistical difference between the two groups(P value of less than 0.05).Group 1 had a median of-1 644.57,a mean of-999.04,a mean standard error of 70.35,and a standard deviation of 15 024.62.Group 2 had a median of-1 641.88,a mean of-998.50,a mean standard error of 70.32,and a standard deviation of 15 019.24.Conclusions Both the current and adjusted rates accurately reflect the true cost of hospitalization for patients.However,the adjusted standard is more closely aligned with the actual costs and the model remains valid.partially address the issue of targeting elderly patients that may arise after the implementation of DRG-PPS payment.
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NSTL
万方数据
