基于DRGs付费方式的术后肺炎患者疾病经济负担评价

Evaluation of economic burden of disease in postoperative pneumonia patients based on DRGs payment method

    摘要
  • 摘要:
    目的 基于DRGs探讨术后肺炎(POP)对医疗资源消耗的影响, 为POP精准防控提供依据。
    方法 选取遂宁市中心医院2024年1月1日-12月31日手术出院患者为研究对象, 其中POP组396例、非POP组34 557例, 比较两组基本情况及资源消耗情况, 按DRGs病组分层分析, 比较两组平均住院日及平均住院费用差异。
    结果 总体POP发病率为1.13%。POP组与非POP组在年龄、入院方式、手术时长等基本情况差异均有统计学意义(P＜0.05), 89.39%的POP发生在术后7 d内。POP组平均住院日及平均住院费用是非POP组的3.80倍、5.49倍, 其各项费用、时间消耗指数和费用消耗指数等均高于非POP组(P＜0.05)。POP组患者主要分布在胃食道十二指肠手术、颅内或开颅手术及胸外科手术相关分组, 除编码163病组平均住院日及平均住院费用, 164病组平均住院日, 无统计学差异, 其余各组平均住院日及平均住院费用差异均有统计学意义(P＜0.05)。
    结论 POP增加医疗资源消耗, 结合DRGs分组可明确其资源消耗差异。胃食道十二指肠手术、颅内或开颅手术等相关分组是POP的防控重点。

     

    Abstract:
    OBJECTIVE To explore the impact of postoperative pneumonia (POP) on healthcare resource consumption based on DRGs, providing a basis for precise prevention and control of POP.
    METHODS Patients discharged after surgery from Suining Central Hospital between Jan. 1 and Dec. 31, 2024, were selected as the study subjects, including 396 cases in the POP group and 34 557 cases in the non-POP group. The basic conditions and resource consumption of the two groups were compared, and stratified analysis was conducted according to DRGs disease groups to compare the differences in average length of hospital stay and average hospitalization expenses between the two groups.
    RESULTS The overall incidence rate of POP was 1.13%. Statistically significant differences were observed between the POP and non-POP groups in terms of age, admission method and surgical duration (P < 0.05). 89.39% of POP cases occurred within 7 days after surgery. the average length of hospital stay and average hospitalization expenses of the POP group were 3.80 times and 5.49 times those of the non-POP group, respectively. The various expenses, time consumption index and expense consumption index were all higher in the POP group than in the non-POP group (P < 0.05). Patients in the POP group were mainly distributed in DRGs groups related to gastroesophageal duodenal surgery, intracranial or craniotomy surgery and thoracic surgery. Except for the average length of hospital stay and average hospitalization expenses in the group 163 and the average length of hospital stay in the group 164, which showed no statistical differences, the average length of hospital stay and average hospitalization expenses in all other groups showed statistically significant differences (P < 0.05).
    CONCLUSIONS POP contributes to increased healthcare resource consumption. Based on DRGs, the differences in resource consumption can be clarified. DRGs related to gastroesophageal duodenal surgery, intracranial or craniotomy surgery, etc., are the key focuses for the prevention and control of POP.

     

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