Influence Of Fee For Single Disease Reform On Hospitalization Expenses

In order to examine the performance of payment related to the diagnosis related groups(DRGs)in Qingdao,by investigating the composition of the hospitalization cost of patients undergoing in the general hospitals in Qingdao and to analyze the characteristics and influencing factors of hospitalization costs in patients in different payment methods,and compare the difference in hospitalization costs among patients between the two payment.To explore the specific performance of DRGs that impacted on hospitalization costs,and to make recommendations for the further development of China's payment reform.Methods:The methods of combining the qualitative and quantitative methods such as literature research,expert consultation,statistical analysis,comparative study.With the help of the medical insurance information platform,there are five diseases of the the information of inpatient cost be selected through the cost list of DRGs according to the principle that clear diagnosis ?mature medical technology?less complications and exact curative effect from 1st January to 30 th June in 2018.The data processing software SPSS 22.0 were used for descriptive analysis,chi-square test and variance analysis.Through the insider interview on hospital management and medical personnel,and analysis the difference and cause of hospitalization costs between two different payment method according to the survey and interview results.The five kind of single disease that difference of these two groups have statistical meaning.The average hospitalization cost of group FFS are generally higher than the group DRGs,sort by cost difference from high to low is cholecystolithiasis?leiomyoma of uterus? benign tumor of thyroid?inguinal hernia?senile cataracts.The difference value from big to small is 7840.83 yuan ? 7032.35 yuan ? 6472.4yuan ? 2538.75 yuan ?1361.7yuan.In terms of composition of hospitalization expenses,The difference of the inspection fee that two groups of senile cataracts is large,the DRGs group is 630.95 yuan lower;the difference of the drug fee?other material fee and inspection fee that two groups of cholecystolithiasis is large,the drug fee of DRGs group is 2640.79 yuan lower;the difference of the drug fee?surgery fee and inspection fee that two groups of benign tumor of thyroid is large;the inspection fee of DRGs group is 2131.69yuanlower;the difference of the surgery fee that two groups of leiomyoma of uterus is large,the DRGs group is 2611.6 yuan lower;the difference of the inspection fee that two groups of inguinal hernia is large,the DRGs group is 2131.69 yuan lower.In terms of hospital day,The average length of stay in patients with senile cataract,cholecystolithiasisand inguinal hernia is concentrated within 5 days;the average length of stay in patients with leiomyoma of uterus and benign tumor of thyroid is concentrated in6-10 days.The payment reform effectively control the hospital expenses of patients that the per capita hospitalization cost of patients in DRGs group of the five diseases was lower than the fee for service group;the payment reform also effectively shortened average length of stay that the ALOS of patients in DRGs group was shorter than the fee for service group.It is suggested that payment method reform of can be promoted by standardizing clinical pathways?strengthening internal and external regulatory functions?rationalizing and controlling medical consumables,and providing new ideas for hospital management departments and administrative departments for public health to carry out work.