针对妇产科合理药物治疗的多学科DRG管理:江省的一项成本分析
Qiqin Zhang1, Geer Zhang1, Shuangneng Yang1
1Women's Hospital, Zhejiang University School of Medicine, 1 Xueshi Road, Hangzhou, 310, 006, PR China.
BMC health services research
|May 27, 2025
概括
将药剂师整合到多学科团队中,提高了产科护理的效率,并在DRG改革下降低了成本. 这种主动的方法优化了药物管理,解决了复杂的病例,提高了医院的整体绩效.
科学领域:
- 卫生经济学 卫生经济学
- 医院管理 医院管理
- 临床药房 临床药房
背景情况:
- 江省在2020年实施了诊断相关小组 (DRG) 支付改革,旨在控制成本和加强医疗保健服务.
- 江现有的DRG模式优先考虑金融指标,可能会忽视医疗理性,特别是在产科护理中.
- 开发了一种创新的产科多学科团队 (MDT) 模型,将药剂师纳入产前决策,从反应性成本控制转向主动药物优化.
研究的目的:
- 评估综合产科多学科团队 (MDT) 模型对医院运营绩效和成本的影响.
- 确定产科诊断相关组 (DRG) 分类中的关键成本驱动因素,特别是OZ13组.
- 根据DRG支付改革,确定影响妇产科患者住院费用的因素.
主要方法:
- 收集和分析了2020年至2024年产科患者的诊断相关组 (DRG) 数据.
- 利用波士顿矩阵分析确定目标疾病群体 (OZ13) 进行深入研究.
- 采用斯皮尔曼相关性,克鲁斯卡尔-瓦利斯H测试,以及一个通用线性模型来识别成本驱动因素和影响因素.
主要成果:
- 实施MDT模型导致时间消耗指数 (TCI) 下降至0.9,成本消耗指数 (CCI) 下降至0.91,案例混合指数 (CMI) 上升至0.51.
- OZ13组在住院费用和药品费用之间显示出强烈的相关性 (p < 0.01),在2020年和2024年之间有显著的支出变化 (p < 0.05).
- 影响OZ13患者费用的关键因素包括经常性流产史,试管婴儿状态,妊娠周,平价,年龄和停留时间.
结论:
- 早期将药剂师纳入MDT管理,将对医院的质量,效率和成本效益产生积极的影响.
- 药品成本是OZ13疾病群体中相当大的可调整支出,需要有针对性的管理策略.
- 在DRG改革下,在复杂的产科病例中,差异化管理方法对于优化护理和成本至关重要.
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