[1]熊 蔓,伍林生.重庆市DRG实施成效评估及问题分析——基于模拟运行阶段[J].卫生经济研究,2022,39(7):28-31.
　XIONG Man,WU Linsheng.Evaluation of Implementation Effectiveness and Problem Analysis of DRG in Chongqing ——Based on Simulation Operation Phase[J].Journal Press of Health Economics Research,2022,39(7):28-31.
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重庆市DRG实施成效评估及问题分析
——基于模拟运行阶段
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卫生经济研究[ISSN:1004-7778/CN:33-1056/F]

卷:
39
期数:
2022年7期
页码:
28-31
栏目:
卫生资源
出版日期:
2022-06-30

文章信息/Info

Title:
Evaluation of Implementation Effectiveness and Problem Analysis of DRG in Chongqing
——Based on Simulation Operation Phase
作者:
熊 蔓1; 伍林生1
1.重庆医科大学马克思主义学院，重庆 400016
Author(s):
XIONG Man;  WU Linsheng
School of Marxism, Chongqing Medical University, Chongqing 400016, China
关键词:
按疾病诊断相关分组; 医保支付方式改革; 试点城市
Keywords:
Diagnosis Related Groups (DRGs);  medical insurance payment reform;  pilot city
分类号:
F840.684
文献标志码:
A
摘要:
目的：回顾重庆市试点医疗机构应用DRG支付方式进行模拟运行付费改革的经验做法，分析有待改进的问题，以期对实际付费工作起到一定借鉴作用。方法：对30家DRG付费试点医疗机构2020年12月—2021年5月两个模拟运行阶段的服务能力、费用运行、服务效率、医疗安全和质量分析等指标进行分类统计分析。结果：模拟阶段三级、二级医疗机构住院患者次均费用降低，三级医疗机构服务效率提高，教学医院、二级医疗机构以及中医院14天和31天再住院率均下降，教学医院费用消耗指数、三级医疗机构31天再住院率降低。同时，存在分组方案、权重费率及配套政策细节验证不充足，信息化水平有待提升，编码版本与系统对接有差异等问题。结论：重庆市DRG模拟运行为正式实施奠定了较好的基础，但也存在一些问题，有待在后期实践中逐步完善。
Abstract:
Objective To review the practices of the pilot medical institutions in Chongqing using the DRG payment method to carry out simulation operation payment reform, in order to provide reference to the actual payment work. Methods Statistical analysis was conducted to classify the service capacity, cost operation, service efficiency, medical safety and quality analysis of 30 DRG payment pilot medical institutions in the two simulation operation phases from December 2020 to May 2021. Results The average per-patient cost of inpatient admission in tertiary and secondary healthcare institutions decreased, service efficiency in tertiary healthcare institutions increased, 14-day and 31-day readmission rates decreased in teaching hospitals, secondary care institutions, and Chinese medicine hospitals, cost consumption index decreased in teaching hospitals, so did 31-day readmission rates in tertiary healthcare institutions. There existed several problems such as insufficient validation of grouping scheme, weighted rates and supporting policy details, inefficient informationization quality, and differences in coding version and system interface. Conclusions The DRG simulation operation stage in Chongqing has laid a good foundation for the future work.

参考文献/References:

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更新日期/Last Update: 2022-06-30