Research on the Optimization of Neonatal Disease Combination Under the Reform of DIP Payment

China Health Insurance ›› 2024, Vol. 0 ›› Issue (3) : 78-82.

China Health Insurance ›› 2024, Vol. 0 ›› Issue (3) : 78-82. DOI: 10.19546/j.issn.1674-3830.2024.3.012
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Research on the Optimization of Neonatal Disease Combination Under the Reform of DIP Payment

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Abstract

Objective: In the context of the revision of the disease classification and payment table in Guangzhou City of Guangdong Province, this study analyzes the issues with the combination of newborn diseases in the 2021 version of the disease classification and payment table for social medical insurance in Guangzhou, and the revised content of the 2022 version, and proves the rationality of neonatal disease types setting after the implementation of the 2022 version. Methods: The paper analyzes the combination of newborn diseases in the 2021 version. Combined with the settlement data of newborn diseases in a designated maternal and child health care medical institution for healthcare security in Guangzhou, descriptive analysis and non-parametric tests were used to compare the DIP score cost and average cost per case in the 2022 version. Results: Due to the quality of data filling in the medical records of medical institutions, there are problems with the combination of newborn diseases in the 2021 version, such as overly detailed grouping operations, inverted scores, and lack of strict differentiation in grouping diagnosis. The 2022 version has been revised to address these issues. After testing, the 2022 version can better reflect the actual consumption of medical resources. Conclusion: The combination of newborn diseases in the 2022 version is more reasonable than that in the 2021 version. The quality of data filling in the medical records of medical institutions has been improved, and the DIP score cost is closer to the actual clinical consumption. The optimization of DIP policy requires participation and cooperation from various departments.

Key words

DIP / combination of neonatal diseases / medical resource consumption

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Research on the Optimization of Neonatal Disease Combination Under the Reform of DIP Payment[J]. China Health Insurance. 2024, 0(3): 78-82 https://doi.org/10.19546/j.issn.1674-3830.2024.3.012

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