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预防医学  2023, Vol. 35 Issue (1): 78-82    DOI: 10.19485/j.cnki.issn2096-5087.2023.01.019.
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疾病诊断相关分组点数付费对产妇分娩住院费用的影响
傅君, 丁苗苗, 朱亚飞
宁波市妇女儿童医院病案统计科,浙江 宁波 315000
Impact of diagnosis-related groups point payment on hospitalization costs of parturition among lying-in women
FU Jun, DING Miaomiao, ZHU Yafei
Department of Medical Records and Statistics, Ningbo Women and Children's Hospital, Ningbo, Zhejiang 315000, China
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摘要 目的 分析疾病诊断相关分组(DRGs)点数付费对产妇分娩住院费用的影响,为减轻产妇负担、节约医疗资源提供参考。方法 通过宁波市某三甲妇女儿童医院住院病案系统和DRG运营分析系统收集2020—2021年分娩产妇的年龄、孕周、产次、住院时间、DRG分组和住院费用等资料,比较DRGs点数付费实施前后产妇分娩住院费用变化,并采用多因素logistic回归模型分析DRGs点数付费与产妇分娩住院总费用的关系。结果 DRGs点数付费实施前后分别纳入10 871和11 505名产妇,年龄≤30岁分别为6 208和6 216人,占57.11%和54.03%。DRGs点数付费实施后产妇分娩住院总费用、材料费和化验费的MQR)分别为8 519.19(2 456.61)、881.38(816.16)和939.00(310.00)元,均低于实施前产妇的9 123.13(2 660.33)、915.57(825.26)和1 036.00(385.00)元(Z=-21.971、-16.061、-27.199,均P<0.001)。多因素logistic回归分析结果显示,调整年龄、住院时间、孕周、产次、分娩方式和并发症后,DRGs点数付费与更低的产妇分娩住院总费用存在统计学关联(OR=0.462,95%CI:0.432~0.494)。结论 DRGs点数付费有利于降低产妇分娩住院费用。
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傅君
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关键词 疾病诊断相关分组点数付费住院费用分娩    
AbstractObjective To examine the effect of diagnosis-related groups (DRGs) point payment on hospitalization costs of parturition among lying-in women, so as to provide the evidence for alleviating the burdens and saving medical resources among lying-in women. Methods Lying-in women's age, gestational age, parity, duration of hospital stay, DRGs grouping and hospitalization costs were collected from the Inpatient Medical Record System and DRG Operation Analysis System in a tertiary women and children's hospital in Ningbo City from 2020 to 2021. The changes of hospitalization costs of parturition were compared among lying-in women before and after DRGs point payments, and the association between DRGs point payments and gross hospitalization costs of parturition was examined among lying-in women using a multivariable logistic regression analysis. Results A total of 11 505 lying-in women after DRGs point payments, including 6 216 women at age of 30 years and below (54.03%), and 10 871 lying-in women before DRGs point payments, including 6 208 women at age of 30 years and below (57.11%), were enrolled. The median (interquartile range) gross hospitalization expenses, material expenses and laboratory testing expenses of parturition were 8 519.19 (2 456.61), 881.38 (816.16) and 939.00 (310.00) Yuan among lying-in women after DRGs point payments, which were significantly lower than those [9 123.13 (2 660.33), 915.57 (825.26), 1 036.00 (385.00) Yuan] among lying-in women before DRGs point payments (Z=-21.971,-16.061 and -27.199, all P<0.001). Multivariable logistic regression analysis showed that DRGs point payment was statistically associated with lower gross hospitalization expenses of parturition among lying-in women after adjustment for age, duration of hospital stay, gestational age, parity, type of delivery and development of complications (OR=0.462, 95%CI: 0.432-0.494). Conclusion DRGs point payment is beneficial to reduce the hospitalization cost of parturition among lying-in women.
Key wordsdiagnosis-related groups    point payment    hospitalization cost    parturition
收稿日期: 2022-08-01      修回日期: 2022-12-03      出版日期: 2023-01-10
中图分类号:  R17  
基金资助:浙江省医药卫生科技计划项目(2020KY880)
通信作者: 丁苗苗,E-mail:dmm.8.28@qq.com   
作者简介: 傅君,硕士,副主任医师,主要从事妇产科、病案统计研究工作
引用本文:   
傅君, 丁苗苗, 朱亚飞. 疾病诊断相关分组点数付费对产妇分娩住院费用的影响[J]. 预防医学, 2023, 35(1): 78-82.
FU Jun, DING Miaomiao, ZHU Yafei. Impact of diagnosis-related groups point payment on hospitalization costs of parturition among lying-in women. Preventive Medicine, 2023, 35(1): 78-82.
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http://www.zjyfyxzz.com/CN/10.19485/j.cnki.issn2096-5087.2023.01.019.      或      http://www.zjyfyxzz.com/CN/Y2023/V35/I1/78
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