协和医学杂志2025，Vol.16Issue(3)：697-702,6.DOI:10.12290/xhyxzz.2025-0008
基于DRG的北京市某三级综合医院住院死亡病例分析
Analysis of Inpatient Mortality Cases in a Tertiary General Hospital in Beijing Based on Diagnosis-related Groups
摘要
Abstract
Objective To analyze inpatient mortality cases in a tertiary general hospital in Beijing based on diagnosis-related groups(DRG),with the aim of providing references for healthcare quality management.Methods We retrospectively collected DRG data of hospitalized patients admitted to a tertiary general hospital in Beijing from January 1,2015,to December 31,2023.Mortality cases were analyzed according to mortality risk stratification,with a focus on the temporal trends,departmental distribution,and DRG composition of low/medium-low mortality risk cases.Results Among 927 304 DRG-classified hospitalizations,2346 cases resulted in death(stratified into 130 low-risk,209 medium-low-risk,411 medium-high-risk,and 1596 high-risk ca-ses),yielding an overall mortality rate of 0.25％.The mortality rates were 0.02％(130/680 939)in the low-risk group and 0.16％(209/130 449)in the medium-low-risk group.From 2015 to 2023,the mortality rate showed a significant downward trend(x2=104.77,P＜0.001).Low/medium-low-risk mortality cases predomi-nantly originated from the Medical Intensive Care Unit(MICU)and ICU(37.8％,128/339).The most fre-quent DRG group among all mortality cases was RW29,while EC 13(Tuberculosis,Operating Room Procedure with Complications/Comorbidities)accounted for the majority of low/medium-low-risk deaths.The top three pri-mary diagnoses were C34.101(Malignant neoplasm of upper lobe of lung),J18.903(Severe pneumonia),and J15.600x005(Acinetobacter baumannii pneumonia).Conclusions Critical care units accounted for the highest proportion of mortality cases,with surgical patients having complications/comorbidities representing the major DRG-related factors for low/medium-low-risk deaths.Hospitals should prioritize these findings by identifying areas for improvement,implementing multidisciplinary case reviews,and strengthening patient safety measures.关键词
疾病诊断相关分组/死亡风险分级/死亡病例/住院患者Key words
diagnosis-related groups/death risk classification/death cases/inpatient分类
医药卫生引用本文复制引用
张宇斐,周炯,马小军,王萧冉..基于DRG的北京市某三级综合医院住院死亡病例分析[J].协和医学杂志,2025,16(3):697-702,6.基金项目
北京协和医学基金会医务管理发展研究公益项目(22323034001) Public Welfare Project of Medical Management Development Research of Union Medical Foundation(22323034001) （22323034001）
