探索临床途径实践,以优化基于资源消耗的DRG成本计算结果
Shu Qian Wu1, Xiao Cui Wang2, Andrew D Boyd3
1Meng Chao Hepatobiliary Hospital, Fujian Medical University, FuZhou, Fujian, China. sldddjy@163.com.
BMC medical informatics and decision making
|August 13, 2025
概括
中国的诊断相关组 (DRG) 支付改革得到了双螺旋模型的增强,显著降低了成本和住院时间,同时改善了患者的治疗结果. 该模型将成本会计与临床途径优化相结合,以更好地利用医疗保健资源.
科学领域:
- 卫生经济学 卫生经济学
- 医疗保健管理的管理
- 临床信息学 临床信息学
背景情况:
- 中国的诊断相关组 (DRG) 支付改革旨在通过成本会计标准化临床途径和优化资源使用.
- 孟肝胆病医院 (MC医院) 是一个三级医疗机构和DRG试点站点,实施了一种创新的"双螺旋模型"以整合这些目标.
研究的目的:
- 评估双螺旋模型在优化临床途径和第三级医院环境中的成本会计方面的有效性.
- 评估该模型对降低成本,住院时间,感染率以及传统中医药 (TCM) 整合的影响.
主要方法:
- 对2022年的医院成本数据进行了回顾性分析,整合了来自医院信息系统 (HIS),实验室信息管理系统 (LIMS) 和医院资源规划 (HRP) 的数据.
- 在医疗服务成本计算中使用了等效系数方法,DRG成本通过项目智能总和汇总.
- 双螺旋模型通过成本差异分析和途径调整促进了临床途径的代优化.
主要成果:
- 这项干预措施使得每病例的成本降低了44.56% (¥4,000),平均住院时间从17.8天减少到12.8天.
- 感染率降低了4.12%,高绩效部门的成本差异较低.
- 传统中医药 (TCM) 的使用量增加了3.7%,但没有对治疗成本产生负面影响.
结论:
- 双螺旋模型成功地将成本会计与临床途径结合起来,从而大大节省成本并保持健康质量.
- 成功采用需要与机构能力和区域资源保持一致,需要先进的健康信息技术 (HIT).
- 该模型在复杂的治疗中最有效,在同质的程序中不那么有效.
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