摘要
目的:评价DRG支付方式对宫腔镜手术住院费用及医疗服务质量的效果。方法:收集2021-2022年安徽省某三甲综合医院697例宫腔镜手术病人数据,按付费方式分为DRG组(n=385)和非DRG组(n=312)。采用描述性统计分析、倾向性评分法、秩和检验,平衡病例间混杂因素后,检验DRG组和非DRG组住院费用及医疗服务质量情况。结果:经倾向性匹配后,DRG组与非DRG组宫腔镜手术病人的年龄、婚姻、住院时间、住院次数、手术级别、切口等级、麻醉方式差异均无统计学意义(P>0.05)。2组病人日均费用、自费金额、一般医疗服务费和护理费差异均有统计学意义(P<0.01);而总费用、诊断费用、手术治疗费、西药费、其他费用)、术前住院时间和是否有出院31 d内再住院计划差异均无统计学意义(P>0.05)。结论:DRG对样本医院宫腔镜手术控费作用不明显,对医疗服务质量水平影响亦不显著,医疗机构在费用结构与服务质量方面仍存在优化管理空间,应结合自身运营特点,对相关指标进行实时、针对性的监测与考核,实现医院控费提质“双控制”。
Objective:To evaluate the effects of DRG payment method on the hospitalization cost and medical service quality of hysteroscopic surgery.Methods:The data of 697 patients treated with hysteroscopic surgery in a tertiary grade A general hospital in Anhui province from 2021 to 2022 were collected,and the patients were divided into the DRG group(n=385)and non-DRG group(n=312)according to payment method.After balancing confounding factors among cases,the descriptive statistical analysis,propensity scoring and rank sum test were used to examine the hospitalization cost and medical service quality of DRG group and non-DRG group.Results:After propensity matching,there was no statistical significance in the age,marriage,length of stay,number of hospitalizations,level of surgery,grade of incision,and mode of anesthesia between two groups(P>0.05).The differences of the average daily cost,out-of-pocket amount,general medical services and nursing costs between two groups were statistically significant(P<0.01);while there was no statistical significance in the total cost(diagnostic cost,surgical treatment cost,western medicines and other costs),duration of preoperative hospitalization,and whether there was a plan for rehospitalization within 31 d of discharge between two groups(P>0.05).Conclusions:The effects of DRG on the cost control of hysteroscopic surgery and quality of medical service in sample hospital are not significant.Medical institutions still have room for optimizing management in terms of cost structure and service quality,and the relevant indicators should be monitored and evaluated in real time according to their own operational characteristics,so as to achieve"double control"of hospital cost control and quality improvement.
作者
刘静
林琳
吕曼辰
薛同斌
张钰
刘雪珍
田帝
吴烨
LIU Jing;LIN Lin;L Manchen;XUE Tongbin;ZHANG Yu;LIU Xuezhen;TIAN Di;WU Ye(Department of Case Management,The First Affiliated Hospital of Anhui Medical University,Hefei Anhui 230022;School of Health Management,Anhui Medical University,Hefei Anhui 230032,China;Emergency Management Office,The First Affiliated Hospital of Anhui Medical University,Hefei Anhui 230022;Human Resources Management Office,The First Affiliated Hospital of Anhui Medical University,Hefei Anhui 230022)
出处
《蚌埠医学院学报》
CAS
2024年第6期779-783,共5页
Journal of Bengbu Medical College
基金
安徽省高等学校哲学社会科学研究项目(2022AH040158)
安徽医科大学医院管理研究所国医科技项目(2023gYkJ01)。
