Objective: Patients with acute pancreatitis from 2019 to 2021 in a tertiary hospital in Zhejiang Province were included in the study to evaluate the changes in patient hospitalization costs before and after the DRGs reform, aiming to provide empirical evidence for the continuous optimization of the policy. Methods: The interrupt time series model was used to analyze the trend of hospitalization costs before and after the implementation of the policy, and Spearman correlation analysis was used to explore the correlation between the total hospitalization costs and the costs of each component. Results: The analysis showed that the total hospitalization cost increased by 1639.3 yuan per month before the reform (P < 0.001), decreased by 1924.1 yuan per month after the reform (P < 0.001), and the drug cost and medical service fee decreased by 910.0 yuan and 480.3 yuan per month, respectively (P < 0.001). After the reform, the medical service fee showed the strongest correlation with the total hospitalization cost (r=0.941, P < 0.001). Conclusion: The study found that with the implementation of DRG reform, the hospitalization cost of acute pancreatitis patients in the sample hospital decreased year by year, indicating that the reform effect was significant. Medical institutions responded effectively to the policy change by strengthening the control of drugs and consumables and standardizing medical behavior. In order to further enhance the regulatory role of DRG policy, it is suggested to adjust the price of medical service to motivate medical personnel, and establish a dynamic adjustment mechanism to optimize the DRG grouping scheme to ensure that the policy better meets clinical requirement and medical practice.
Key words
DRG /
interrupted time series analysis /
hospitalization costs
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
References
[1] 王亦冬,孙志楠,陈颖.典型国家DRG研究与实践进展综述及其对我国的启示[J].中国卫生经济,2021,40(06):91-96.
[2] 浙江省医疗保障局关于印发浙江省医疗保障疾病诊断相关分组(ZJ—DRG)细分组目录(1.1版)的通知[EB/OL].(2021-10-27)[2022-03-13].http://ybj.zj.gov.cn/art/2021/10/27/art_1229225623_2370929.html.
[3] 陈卫昌.急性胰腺炎诊治进展[J].临床内科杂志,2023,40(09):584-587.
[4] 孙建,薛巧云,姜婷.急性胰腺炎患者住院费用影响因素分析[J].中国病案,2021,22(10):63-66.
[5] 邵华,王琦琦,胡跃华,等.中断时间序列分析及其在公共卫生领域中的应用[J].中华流行病学杂志,2015,36(9):1015-1017.
[6] 林凯,王振宇,戴笑韫,等.医疗服务价格调整对公立医院收入结构的影响研究——基于成分数据分析方法[J].中国医院管理,2021,41(04):47-51.
[7] 阮爱萍.公立医院医疗服务价格结构调整策略研究——基于规范医疗行为的视角[J].卫生经济研究,2023,40(10):30-31.