目的: 本研究从民营专科医院角度出发,分析DRG付费模式下民营专科医院的运营现况,总结医院运营发展面临的挑战与问题,并提出针对性的运营发展策略。方法: 选取青岛市某三级民营专科医院2022年1月1日至8月31日以及2023年1月1日至8月31日住院病例共6006份。运用描述性分析法,从医疗服务能力、财务类、医疗质量及运营效率四个维度指标出发,对入组DRG病例情况进行基本分析,采用间断时间序列模型评估DRG付费对该院运营的影响程度。结果: 在DRG付费改革下,该院面临病组权重赋分值低,诊疗价值难体现;运营收益下降,学科建设发展受影响;医疗服务质量下降,诱发不合理诊疗行为;科室缺乏DRG付费政策认知,存在执行不足等问题。结论: 民营专科医院需明确DRG政策要求,通过精准病组权重赋分,规范病案管理体系;构建精细化管理体系,助推医院运营发展;以医疗质量为核心,优化绩效考核方案;提升DRG培训质量,促进学科建设等对策,并结合医院发展实际作出动态调整,提升医院的可持续发展能力。

Objective: From the perspective of private specialized hospitals, this study analyzes their current operating status under the DRG payment, summarizes the challenges and problems faced by the operation and development, and proposes targeted operation and development strategies. Methods: A total of 6006 inpatient medical records from January 1, 2022 to August 31, 2022, and January 1, 2023 to August 31, 2023, were selected from a tertiary private specialized hospital in Qingdao City. This study uses the descriptive analysis method to conduct a basic analysis of the medical records of DRG from the four dimensions of medical service capacity, finance, medical quality and operational efficiency. It adopts the interrupted time series model to evaluate the impact of DRG payment on the operation of hospital. Results: Under the reform of the DRG payment,the hospital is faced with low weight of patient groups, making it difficult to reflect the value of diagnosis and treatment. The income has declined, and the development of discipline construction has been affected. The quality of medical services has declined, inducing unreasonable diagnosis and treatment behaviors. Departments lack awareness of the DRG payment policy, resulting in insufficient execution. Conclusions: Private specialized hospitals need to clarify the requirements of the DRG policy, and standardize the medical record management system through the weighting and scoring of precise disease groups. build a refined management system to promote the operation and development of the hospital. optimize the performance appraisal plan with medical quality as the core, improve the quality of DRG training, promote discipline construction, and make dynamic adjustments in combination with the actual development of the hospital, so as to improve the sustainable development ability of the hospital.