Analysis on the influence of Diagnosis-Intervention Packet Reform on the Average Length of Hospital Stay in a Three A and Tertiary Hospital
Objectives From the point of view of the influence of payment according to disease value on the average length of stay of a Three A and Tertiary Hospital,the changes of the average length of stay of the hospital under the DIP payment reform are studied,so as to provide ideas for hospitals in pilot areas to carry out medical services and quality management under DIP payment.Methods The front page information of inpatient medical records from January 1st,2020 to December 31st,2021 before and after DIP payment was exported from the medical record of management system of a Three A and Tertiary Hospital.According to the DIP subcategories in 2020 and 2021,the correct rates of major diagnoses and operations in 2020-2021 and the CMI values published in the performance assessment of third-level public hospitals in the pilot areas and hospitals,Excel and SPSS23.0 were used to statistically analyze the average length of hospital stay,the average length of hospital stay before and after surgery,the average length of hospital stay before and after surgery,the value of CMI,the number of DIP groups,and the accuracy of main diagnosis and main surgical selection.The differences before and after DIP payment were compared by T-test or Chi-square test.Results After DIP payment,the average length of stay in the whole hospital decreased by 0.52 days,and the average length of stay before and after surgery decreased by 0.08 and 0.82 days,respectively.Independent sample T-test was conducted respectively,showing statistical differences.At the same time,32 of the 36 clinical departments in the hospital achieved a decrease in the average length of stay,among which the surgery department decreased by 0.66 days and the internal medicine decreased by 0.38 days.The independent sample T-test of 20 departments showed statistical differences.In 2021,the CMI value of the hospital increased by 0.1 and the number of DIP groups increased by 514.In 2021,the accuracy of main diagnosis and main surgical selection increased by 2.60%and 2.40%,respectively,with statistical difference in Chi-square test.Conclusions After the implementation of DIP payment,the Three A and Tertiary Hospital would transform its mode of management,improve its internal management level and medical service efficiency,and improve the treatment capacity of various diseases,so as to achieve a rapid decline in the average length of stay,the average length of stay before and after surgery,and improve the treatment level of the hospital.
DIP paymentThe average length of stayThe mode of managementQuality of medical careEfficiency of service
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NSTL
万方数据
