中国卫生事业管理2025，Vol.42Issue(5)：520-525,6.
DRG高倍率病例住院费用结构及影响因素分析
Analysis of Hospitalization Cost Structure and Influencing Factors of DRG High-Rate Cases Sampled with A Terti-ary Hospital in Chongqing
摘要
Abstract
Objective To deeply analyze the enrollment characteristics of high-rate cases under the payment by disease diag-nosis grouping(DRG),explore the internal structure of their hospitalization costs and their influencing factors,and provide deci-sion-making references for the health insurance department and healthcare institutions.Methods 2 362 high-rate cases were col-lected from a tertiary hospital in Chongqing in 2023.Descriptive analysis of their enrollment characteristics was conducted.Gray correlation analysis was used to explore the correlation among the hospitalization costs of high-rate patients and their internal costs.One-way analysis,multivariate linear regression,and the random forest model were used to comprehensively analyze the influencing factors of the hospitalization costs of high-rate patients and their importance degree.Results Compared with normal-multiplicity cases,high-rate cases had longer hospital duration,higher hospitalization costs,and older patients,but lower rela-tive weights(RW).The top 3 correlations in gray correlation analysis of hospitalization costs for high-rate cases were ranked as laboratory fees,examination fees,and drug fees.The number of days of hospitalization,complication status,and grade of surgery were the main influencing factors of hospitalization costs for high-rate cases.Conclusion Medical insurance bureau should opti-mize the criteria for identifying high-rate cases and grouping criteria for DRG.Medical institutions should optimize the clinical pathway and diagnostic and treatment process,and strengthen the cost management.关键词
DRG/高倍率病例/住院费用/费用结构/影响因素Key words
DRG/high-multiplicity cases/hospitalization cost/cost structure/influencing factors分类
医药卫生引用本文复制引用
谭博文,张伟,蒋祎..DRG高倍率病例住院费用结构及影响因素分析[J].中国卫生事业管理,2025,42(5):520-525,6.基金项目
国家社科基金一般项目"中国与太平洋岛国公共卫生合作策略研究"(23BGJ055) （23BGJ055）
