| 摘要: |
| 目的
在分析住院次均费用上升的结构变动基础上，依托DRGs数据探讨住院费用管理新模式，为持续改进费用管理模式作铺垫，为住院费用考核提供依据。方法 利用2013—2014年数据对比分析住院费用的涨幅及其结构变动，并回顾模拟DRGs病组费用的变动趋势。结果 全体人群住院费用上涨8.5%，医保人群费用涨幅7.8%，耗材费用上涨22.5%；不同病组费用进展存在差异，RC19和RU29病组次均费用下降。结论 医保人群取得一定控费效果，耗材成为费用增长的驱动因素，科室层级的粗放型指标管理模式需要逐步向DRGs病组细化。DRGs模式下的费用管理是一项系统工程，需要依托病案编码和信息系统双引擎，需要建立个体化的费用考核体系。 |
| 关键词: 诊断相关分组 费用管理 专科医院 |
| DOI： |
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| 基金项目: |
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| Strategy Study on Payment Management by DRGs |
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| Abstract: |
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Objective
To analyze the structural variation of inpatient fee and annual alteration of DRGs grouped data, and to make a stepping stone for further continuous improvement management and assessment. Methods Making a differential analysis of the annual rising and structural variation between 2013 and 2014, and retrospectively simulating the changing tendency of representative DRGs grouped data. Results The average hospitalization expense of all inpatients rose 8.5%，and patients with medical insurance rose 7.8%；the material cost elevated 22.5%；there were significant differences among DRGs grouped expenses，for instance the markedly declining of RC19 and RU29 groups. Conclusion The cost control effort of medical insurance inpatients is conspicuous，and material cost becomes a new driving force to medical cost expansion；traditional extensive management must be refined by the technique of DRGs. DRGs mode of medical cost management is a systematic project，medical record coding and information technology are indispensable，and individualized evaluation system for clinical departments is highly needed. |
| Key words: DRGs,expense management,special hospital |
