目的: 分析高倍率病例入组特征及费用结构,为进行有针对性的入组控制提供科学依据。方法: 选取安徽省某三级甲等医院2022年1月—10月1468例高倍率病例进行DRG评价,分析DRG高倍率病组的入组特征及住院费用与各类分项费用的灰色关联度。结果: 高倍率病例住院时长较长,严重并发症/合并症情况较多,病组难易系数较高,临床对DRG认识不足,耗材类与住院总费用关联度最强。结论: 建议试行对点科室包保联动,重点关注高值耗材使用,加强高倍率审核与特病单议。

Objective: The paper analyzes the characteristics and cost structure of extremely expensive case enrollment, and provides the scientific basis for targeted enrollment control. Method: 1468 extremely expensive cases from a tertiary hospital in Anhui Province from January to October 2022 were selected for DRG evaluation. The enrollment characteristics of extremely expensive cases in DRG were analyzed, and the grey correlation analysis method was used to determine the correlation between each sub-item cost and the total hospitalization cost. Result: Extremely expensive cases have longer hospitalization time, more serious complications/comorbidities, higher difficulty coefficient of the disease group, more insufficient clinical understanding of DRG, and the strongest correlation between consumables and total hospitalization costs. Conclusion: It is recommended to pilot the linkage of point-to-point department warranty, with a focus on the use of high-value consumables, and to strengthen audits of extremely expensive cases and special disease discussions.