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通过基于DRG的支付系统改善了在医院获得的感染的管理:中断时间序列分析
Yuhua Yuan1, Yanqiu Wang2, Weiwei Huang3
1Department of Infection Prevention and Control, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, No. 3 Qingchun East Road, Shangcheng District, Hangzhou, Zhejiang, 310016, China.
与诊断相关的群体 (DRG) 支付系统显示了改善发展中国家医院获得感染 (HAI) 管理的前景. 实施导致HAI率的长期显著下降,并减少了住院时间.
科学领域:
- 卫生经济学 卫生经济学
- 传染病流行病学 传染病流行病学
- 医疗保健管理的管理
背景情况:
- 与诊断相关的群体 (DRG) 支付系统在高收入国家建立,以改善医疗保健质量和成本.
- 在发展中国家,DRG系统对医院获得感染 (HAI) 管理的影响尚不清楚.
研究的目的:
- 评估DRG支付系统对中国公立医院HAI管理的有效性.
- 评估HAI发病率和DRG实施后相关因素的变化.
主要方法:
- 采用了通用添加模型的中断时间序列分析.
- 分析了来自中国江省9家公立医院的HAI监测数据 (2016年1月至2023年9月).
- 评估了HAI发病率,住院时间和DRG实施后患者人口统计数据的变化.
主要成果:
- 从2020年1月到2023年9月,HAI发病率每月显著下降0.0072%,从2020年1月到2023年9月.
- 2020年1月,HAI利率没有立即变化,但检测到长期显著下降.
- 感染前住院时间减少,女性患者比例的增加趋势稳定了DRG后的采用.
结论:
- 据了解,DRG支付系统的实施似乎对发展中国家的HAI管理做出了积极贡献.
- 结果表明,通过采用DRG,改善医疗保健质量和提高患者安全.
- 这项研究为其他正在实施类似医疗改革的发展中国家提供了宝贵的见解.
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