与诊断相关的基于组的报销和病例组合指数的比较,在被诊断为营养不良的患者之前和之后,在住院患者中进行了修改营养不良诊断
Xiangrui Li1, Lihua Yuan2, Bo Gao1
1Department of Clinical Nutrition, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nan-jing University, Nanjing, China.
准确的营养不良诊断显著增加了诊断相关小组 (DRG) 支付和案例混合指数 (CMI). 适当的营养评估和编码可以改善医院的财务状况和护理质量.
科学领域:
- 医学经济学 医学经济学
- 临床营养学 临床营养学
- 医疗保健管理的管理
背景情况:
- 不准确的营养不良诊断会对医院补偿和病例混合指数 (CMI) 有负面影响.
- 由于营养编码不佳,诊断相关小组 (DRG) 的支付减少了.
- 现有的诊断实践未能捕捉到营养不良的全部严重程度.
研究的目的:
- 评估实施标准化营养诊断对DRG支付的影响.
- 评估修改并发症组如何影响病例混合指数 (CMI).
- 确定准确的营养不良编码的财务和质量效益.
主要方法:
- 对2022年1月至6月期间入院的254名患者的回顾性分析.
- 用患者生成的主观总体评估 (PG-SGA) 进行营养评估.入院后24小时内.
- 在营养诊断修订之前和之后的DRG和CMI值的重新计算和比较.
主要成果:
- 在122名患者中诊断出严重营养不良;111名患者的并发症组发生了变化.
- 中位数DRG医院内部控制标准从12006.09增加到13797.19 (p=0.01).
- 中位数CMI显著从0.91增加到1.04 (p=0.026),炎症性肠病 (IBD) 患者的显著变化.
结论:
- 准确识别和编码营养不良对于适当的DRG补偿至关重要.
- 改善营养诊断可以提高医院的经济可持续性.
- 正确的编码有助于改善整体医疗质量和财务健康.
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