在2012-2019年期间,法国DRG分类系统内患者成本变化的持续不一致
1Paris School of Economics (PSE), PSE-ENS, 48 Boulevard Jourdan, Paris, 75012, France. carine.milcent@psemail.eu.
Health economics review
|October 30, 2025
概括
法国诊断相关小组 (DRG) 系统.
科学领域:
- 卫生经济学 卫生经济学
- 医疗保健管理的管理
- 公共卫生政策 公共卫生政策
背景情况:
- 2009年法国的诊断相关小组 (DRG) 改革引入了四个严重程度.
- 这一改革旨在与美国医疗保险严重性诊断相关小组 (MS-DRG) 系统保持一致.
- 法国国家医疗保险 (NHI) 使用DRG用于公共和私人医院的报销.
研究的目的:
- 评估法国DRG分类改革的有效性.
- 分析医院资源成本变化在DRG内部和之间.
- 评估严重程度分类在捕捉成本差异方面的充分性.
主要方法:
- 从2012年到2019年对医院资源成本数据的实证分析.
- 专注于四种不同的健康状况的变化.
- 对相同病理 (DRG-root) 的DRG内部和DRG之间成本变化的检查.
主要成果:
- 一个适合所有严重程度分类的方法是不够的.
- 在DRG严重程度的成本置信区间中观察到显著的重叠.
- 在DRG内部的成本变化往往是由医院特征等非严重性因素驱动的.
结论:
- 目前的法国DRG系统不足以捕捉与严重性相关的成本差异.
- 建议对DRG分类采用量身定制的,个别案例的方法.
- 需要进行修订,以减少财务差异,并防止激励患者选择.
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