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卫生经济研究[ISSN:1004-7778/CN:33-1056/F]

卷:

43

期数:

2026年01期

页码:

77-80,85

栏目:

医院管理

出版日期:

2026-01-06

文章信息/Info

Title:

Research on Refined Management Strategies for DRG Disease Groups in Clinical Departments

作者:

杨 盼¹; 孙 航¹; 魏 波¹; 王志伟¹

1.徐州医科大学附属医院，江苏 徐州 221006

Author(s):

YANG Pan;  SUN Hang;  WEI Bo;  WANG Zhiwei

The Affiliated Hospital of Xuzhou Medical University, Xuzhou Jiangsu 221006, China

关键词:

DRG病组; 精细化管理; 资源配置

Keywords:

DRG disease groups;  refined management;  resource allocation

分类号:

R197.3

文献标志码:

A

摘要:

目的：探索医院临床科室DRG病组精细化管理现状，提出差异化管理策略。方法：基于徐州市某三甲医院2024年出院患者的DRG结算数据，采用波士顿矩阵和患者规模模型对917个DRG病组进行分类；利用熵权TOPSIS法量化病组多维指标，结合秩和比法验证分类稳健性，从治疗能力、医疗效率、费用管理三个维度对72个控制病组进行分档评价。结果：临床科室DRG病组分为专科技术类、教学培养类和问题整改类；问题整改类中的控制病组进一步可分为三档，在精细化管理中，第三档（12个病组）建议向教学培养类转化，第二档（49个病组）适合门诊化管理，第一档（11个病组）建议下沉基层。结论：医院应建立“分类施策—动态优化”机制，制定差异化的临床科室资源配置方案，实现“控费—提质—发展”协同，进而推动分级诊疗体系建设。

Abstract:

Objective To explore the current status of refined management of DRG disease groups in hospital clinical departments and propose differentiated management strategies. Methods Based on DRG settlement data of patients discharged in 2024 from a tertiary hospital in Xuzhou City, the Boston Matrix and patient volume model were used to classify 917 DRG groups. The entropy-weighted TOPSIS method was applied to quantify multi-dimensional indicators of disease groups, and the Rank Sum Ratio(RSR) method was employed to validate classification robustness. Control disease groups were tiered and evaluated from three dimensions: treatment capability, medical efficiency, and cost management. Results DRG groups in clinical departments were categorized into specialized technical, teaching and training, and problem rectification groups. Control disease groups under the problem rectification category were further tiered into three levels using: Tier 3(12 groups) were recommended for transfer to teaching and training categories; Tier 2(49 groups) were suitable for outpatient-oriented management; and Tier 1(11 groups) were recommended for referral to primary healthcare facilities. Conclusion Hospitals should establish a "categorized strategies- dynamic optimization" mechanism, formulate differentiated resource allocation plans for clinical departments, and achieve the synergistic goals of "cost control, quality improvement, and sustainable development", thereby promoting the construction of a hierarchical diagnosis and treatment system.

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更新日期/Last Update: 2026-01-06