基于路径分析的视角验证慢性肾衰竭DRGs分组流程

刘霞; 邱杰; 斯琴

引用本文：刘霞, 邱杰, 斯琴.基于路径分析的视角验证慢性肾衰竭DRGs分组流程[J].中国卫生政策研究,2014,7(8):68-72

基于路径分析的视角验证慢性肾衰竭DRGs分组流程

投稿时间：2014-03-08 修订日期：2014-05-28 PDF全文浏览 HTML全文浏览

刘霞¹, 邱杰², 斯琴²

1. 新疆医科大学公共卫生学院新疆乌鲁木齐 830011;
2. 新疆医科大学第一附属医院新疆乌鲁木齐 830054

摘要:目的：采用路径分析对慢性肾衰竭病住院费用各相关因素进行分析，以获取DRGs分组的主要影响因素，为复杂类型病种DRGs分组流程提供方法学上的借鉴和思路，为医保政策制定提供参考。方法：收集新疆某三级甲等综合医院2012年肾病科慢性肾衰竭病例及患者相关资料，应用路径分析对其住院费用影响因素进行分析，获得慢性肾衰竭DRGs分组流程主要影响因素。结果：慢性肾衰竭住院患者的医疗费用主要由治疗费、药费、检查费用构成，影响因素主要包括住院天数、透析方式、是否ICU、附加诊断个数、并发症、年龄分组等。结论：为达到医、患、保三方认同的住院费用支付方式的适宜路径，DRGs分组流程应结合本地区、本医院的数据加以分析后，确定分组因素，有目的的进行费用控制。同时DRGs—PPS可以尝试使用路径分析对实际的病种及费用进行分析后再进行DRGs分组。

关键词:慢性肾衰竭 DRGs 路径分析住院费用分组流程

Verification of DRGs packet flow in chronic renal failure with path analysis

LIU Xia¹, QIU Jie², SI Qin²

1. Public School of Xinjiang Medical University, Urumqi Xinjiang 830011, China;
2. Frist Affiliate Hospital of Xinjiang Medial University, Urumqi Xinjiang 830054, China

Abstract:Objective: In order to provide reference for healthcare sector policy formulation and a methodological reference to control complicated medical fees, path analysis has been used to analyze DRGs packet flow in patients with chronic renal failure. Methods: the chronic renal failure cases and related data in three general hospitals of Xinjiang in 2012 were collected. The main determinants were found using path analysis. Results: For patients with chronic renal failure, medical expenses mainly consisted of treatment costs, pharmaceutical fees, and examination fees, while the determinants included the length of hospital stay, methods of dialysis, the use of ICU, the additional number of diagnoses, complications, and age group. Conclusion: The main source of expenses in patients with chronic renal failure was treatment fees, pharmaceutical fees, and examination fees. It has been suggested that the DRGs packet process should be combined with the region and hospital data for analysis. DRGs-PPS should attempt to use path analysis of disease before preparing DRGs packets.

Key words:Chronic renal failure DRGs Path analysis Hospitalization expenses Packet flow

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