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| 投稿时间： 2015-08-12 最后修改时间： 2015-08-30 摘要点击次数: 3384 全文下载次数: 7 |
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| 引用本文：胡敏, 祝菁菁, 朱碧帆,等.上海市三级医院疾病诊断分组系统的模拟与评估[J].中国卫生政策研究,2015,8(9):19-24 |
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| 胡敏1, 祝菁菁1, 朱碧帆1, 茅雯辉1, 岑珏2, 孙木3, 许岩2, 高解春4, 陈文1 |
1. 复旦大学公共卫生学院 上海 200032;
2. 上海申康医院发展中心 上海 200041;
3. 上海交通大学医学院附属瑞金医院 上海 200025;
4. 上海市红十字会 上海 200040 |
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| | 摘要:本研究利用上海市37家三级公立医院2013年12月的所有138 477条出院病例数据,根据本土化的病种分组器对其进行疾病分组,选用各组的变异系数(CV)指标对各组次均费用的离散度进行分析,以评价病种分组系统的适宜性,并设置各病种难度系数(相对权重)。研究发现基于危重度的疾病诊断分组系统适宜性较好,一致性也很高。在今后的研究中应收集更为详细的费用信息以体现医疗服务中的劳务和技术价值,并且进一步完善疾病分组,因地制宜地应用分组权重。 | |
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关键词:疾病诊断分组 疾病危重度 适用性 变异系数
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| Stimulation and assessment of the diagnosis related grouping system in Shanghai tertiary hospitals |
| HU Min1, ZHU Jing-jing1, ZHU Bi-fan1, MAO Wen-hui1, CEN Jue2, SUN Mu3, XU Yan2, GAO Jie-chun4, CHEN Wen1 |
1. School of Public Health, Fudan University, Shanghai 200032, China;
2. Shanghai Shenkang Hospital Development Centre, Shanghai 200041, China;
3. Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China;
4. Red Cross Society of China, Shanghai Branch, Shanghai 200040, China |
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| | Abstract:This paper uses the data collected from 138,477 patient discharge records of 37 Shanghai tertiary public hospitals in December 2013 and classifies all the records into different groups by using a localized diagnosis related group tool. The coefficient of variation index (CV) of each group was used to analyze the dispersion of average hospital cost per inpatient day for each group, in order to evaluate the suitability of diagnosis related group systems and to set the coefficients of difficulty (relative weights) for each disease. The study has found that severity-based diagnosis related group systems are more suitable and consistent. However, future studies should collect more detailed information on health costs in order to reflect the value of health professionals and technologies and therefore further improve diagnosis related classification and develop new systems that can be adapted to local conditions by applying the weights of different groups. | |
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