DRG支付方式下医院感染与医疗资源消耗的关联

Correlation between hospital-acquired infections and medical resource consumption under the DRG payment method

  • 摘要:
    目的 分析疾病诊断相关分组(DRG)支付方式下的医院感染对医疗资源消耗的影响。
    方法 收集浙江省人民医院2022-2023年所有出院患者病历信息和结算清单信息, 基于浙江省医疗保障局疾病诊断相关分组(ZJ-DRG)1.0版分组, 利用时间消耗指数、费用消耗指数、住院日、住院总费用及各项费用明细等指标对院感组和非院感组病例进行分析。
    结果 纳入研究的268 278份病例中, 感染病例2 186份, 感染率0.81%。其中内科DRG病组、外科DRG病组、操作DRG病组感染率分别为0.86%(917/105 916)、0.82%(1 069/131 112)、0.64%(200/31 250), 院感组时间消耗指数、费用消耗指数均高于非院感组(P<0.05)。RW21组院感组住院日、住院总费用、各项费用明细均高于非院感组(P<0.05)。BB21组院感组住院日、住院总费用、药品费、治疗费、材料费、化验费、检查费、其他费均高于非院感组(P<0.05)。GK11组院感组的住院日、住院总费用、药品费、材料费、化验费、其他费均高于非院感组(P<0.05)。对时间消耗指数影响较大的为骨(关节)感染、呼吸道感染、感染性发热等;对费用消耗指数影响比较大的是呼吸道感染、骨(关节)感染、泌尿道感染等。
    结论 医院感染会造成医疗资源的额外消耗, 通过对DRG病组相关医疗资源消耗的分析, 可为医院感染控制提供重点监测病组, 帮助相关部门及临床科室提前采取干预措施, 加强重点防范, 减少医院感染发生, 缩短住院日。

     

    Abstract:
    OBJECTIVE To analyze the impact of hospital-acquired infections on medical resource consumption under the diagnosis-related group (DRG) payment method. METHOD Medical record information and settlement lists of all discharged patients from Zhejiang Provincial People′s Hospital from 2022 to 2023 were selected. Based on the Zhejiang Provincial Medical Insurance Bureau′s diagnosis-related groups (ZJ-DRG) Edition 1.0, indicators such as time consumption index, cost consumption index, length of stay, total hospitalization costs and detailed cost breakdowns were used to analyze cases in the hospital-acquired infection group and the non-hospital-acquired infection group.
    RESULTS Among the 268 278 cases included in the study, 2 186 were infected, with an infection rate of 0.81%. The infection rates for medical DRG disease group, surgical DRG disease group, and procedural DRG disease group were 0.86% (917/105 916), 0.82% (1 069/131 112), and 0.64% (200/31 250), respectively. The time consumption index and cost consumption index were higher in the hospital-acquired infection group than in the non-hospital-acquired infection group (P < 0.05). In the RW21 group, the length of stay, total hospitalization costs and detailed cost breakdowns were all higher in the hospital-acquired infection group than in the non-hospital-acquired infection group (P < 0.05). Similarly, in the BB21 and GK11 groups, the hospital-acquired infection group had high length of stay, total hospitalization costs, medicine fees, treatment fees, material fees, laboratory fees, examination fees and other fees compared to the non-hospital-acquired infection group (P < 0.05). Bone (joint) infections, respiratory infections, and infectious fever had a significant impact on the time consumption index, while respiratory infections, bone (joint) infections and urinary tract infections had a relatively great impact on the cost consumption index.
    CONCLUSIONS Hospital-acquired infections result in additional consumption of medical resources. By analyzing the consumption of medical resources related to DRG disease groups, key monitoring disease groups for nosocomial infection control can be identified, which can aid relevant departments and clinical departments in taking early intervention measures, strengthen key prevention efforts, reduce the incidence of nosocomial infections, and shorten the length of stay.

     

/

返回文章
返回