DRGs视角下医改对肿瘤专科医院的绩效影响分析
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摘要
目的分析DRGs视角下医药分开综合改革政策对肿瘤专科医院的绩效影响,为改革的进一步推进提供支撑。方法回顾性检索2016年1月—2018年3月病历资料,采用χ~2或t检验来推断改革前后的绩效影响。结果改革后,外地医保患者比例同比上涨3.28%,外科出院病人比例下降5.23%,平均住院日下降了0.53天,次均药费下降2 652.36元,DRGs组数增加9.78%,CMI下降5.49%。结论医药分开综合改革,实现了患者就医获得感的提升,但给DRGs绩效考核手段带来不确定性,需要不断探索改革期间的绩效评价模型。
Objective To evaluate the impact of separating drug sales from medical services reform on the performance of oncology hospital from the perspective of DRGs,and to support the further advancement of the reform. Methods Data of hospitalized patients from January,2016 to March,2018 was retrospectively collected to infer the impact of performance before and after reform by using χ~2 or t tests. Results After reform, the proportion of non-Beijing medical insurance patients rose by 3.28% year by year,the proportion of patients discharged from the surgery departments decreased by 5.23%,and the average length of hospital stay decreased by 0.53 days;the average cost of drugs decreased by 2652.36 yuan,CMI decreased by 5.49%,and the number of DRGs groups increased by 9.78%. Conclusion Separating drug sales from medical services reform improves the patients' sense of obtaining medical treatment,but it brings uncertainty to performance assessment based on DRGs. So it is necessary to explore the performance evaluation model constantly during the reform.
Objective To evaluate the impact of separating drug sales from medical services reform on the performance of oncology hospital from the perspective of DRGs,and to support the further advancement of the reform. Methods Data of hospitalized patients from January,2016 to March,2018 was retrospectively collected to infer the impact of performance before and after reform by using χ~2 or t tests. Results After reform, the proportion of non-Beijing medical insurance patients rose by 3.28% year by year,the proportion of patients discharged from the surgery departments decreased by 5.23%,and the average length of hospital stay decreased by 0.53 days;the average cost of drugs decreased by 2652.36 yuan,CMI decreased by 5.49%,and the number of DRGs groups increased by 9.78%. Conclusion Separating drug sales from medical services reform improves the patients' sense of obtaining medical treatment,but it brings uncertainty to performance assessment based on DRGs. So it is necessary to explore the performance evaluation model constantly during the reform.
引文
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[8]刘利,武爱文,王楠,等.DRGs视角下胃癌手术住院患者专科服务绩效评价分析[J].中国医院管理,2017,37(12):39-41.
[2]北京市卫生和计划生育委员会.北京医药分开综合改革一周年新闻发布会[EB/OL].(2018-04-20)[2018-05-10].http://wjw.beijing.gov.cn.
[3]庄昱,周书铎,杨朔,等.北京市医药分开综合改革对门急诊费用控制的机制研究[J].中国卫生政策研究,2017,10(12):9-14.
[4]冷家骅,刘忆,陈治水,等.北京市医药分开综合改革对肿瘤专科医院的影响-基于北京某肿瘤医院医保数据的实证分析[J].中国卫生政策研究,2017,10(12):15-20.
[5]刘建楠,周典.城市公立医院综合改革前后住院费用比较分析--以安徽省某三甲医院为例[J].中国医院管理,2016,36(7):23-25.
[6]金萍妹.某三级甲等肿瘤医院药品零差率实施效果分析[J].中国医院管理,2017,37(6):14-16.
[7]宋杰,陈勇,尹航.北京医药分开试点成效及启示--以北京朝阳医院为例[J].中国卫生政策研究,2016,9(9):31-34.
[8]刘利,武爱文,王楠,等.DRGs视角下胃癌手术住院患者专科服务绩效评价分析[J].中国医院管理,2017,37(12):39-41.