Ding Sheng, Jiang Xiaowan, Zheng Yuming, Feng Tao, Mao Hong, Chen Zhi, Cai Wei, Wang Zhongjing
Department of Endocrinology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Key Laboratory for Molecular Diagnosis of Hubei Province, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Ann Transl Med. 2022 Feb;10(4):167. doi: 10.21037/atm-22-147.
To evaluate the use of the diagnosis-related groups (DRGs) tool to promote the diagnosis/treatment ability and quality of the endocrinology department under the new policy of grouping payment-related to disease diagnosis.
We compared the income structure of the endocrinology department in a 3a general hospital between the first half of 2019 and the same period in 2021. We also observed the changes in cost efficiency indexes (CEIs), time efficiency indexes (TEIs), case-mix index (CMI), number of DRGs, risk weight (RW) proportion, and surgery number in the inpatient department. Furthermore, the distribution of inpatients with diabetes of the whole hospital and the improvement of treatment efficiency indexes of the sub-specialty department were analyzed.
In the first half of 2021, compared with the same period of 2019, the total revenue of the endocrinology department decreased by 20.05%, the average hospitalization cost decreased by 11.72%, the CEI decreased from 1.31 to 1.06, and the TEI decreased from 0.74 to 0.64. Additionally, the number of DRGs increased from 162 to 176, the average CMI value increased from 0.80 to 0.84, and the proportion of RW 1-5 cases increased. Moreover, the number of surgical cases increased by 60.50%, minimally invasive surgery increased by 53.54%, grade 4 surgery increased by 66.67%, and the proportion of entering the clinical pathway increased from 77.76% to 86.64%. From May to August, 2021, the admission rate of endocrinology sub-specialty increased significantly, the number of DRGs showed an increasing trend, and the CEI and TEI decreased significantly. In the first half of 2021, inpatients with diabetes in the departments of rehabilitation, neurology, nephropathy, ophthalmology, and general administration accounted for 21.99-38.54%.
The DRGs tool can be used to improve the clinical diagnosis and treatment ability of the endocrinology department, as well as optimize the CEI, TEI, CMI, and RW values. It is an effective way to promote the development of the endocrinology department under the new DRGs payment policy, carry out blood glucose management in the hospital, build endocrinology sub-specialties, and improve surgical and operation capacity.
在疾病诊断相关分组付费新政策下，评估诊断相关分组（DRGs）工具对提升内分泌科诊疗能力及质量的作用。
比较某三甲综合医院内分泌科2019年上半年与2021年同期的收入结构。同时观察住院部成本效率指标（CEIs）、时间效率指标（TEIs）、病例组合指数（CMI）、DRGs数量、风险权重（RW）比例及手术例数的变化。此外，分析全院糖尿病住院患者分布情况及亚专科治疗效率指标的改善情况。
2021年上半年，与2019年同期相比，内分泌科总收入下降20.05%，平均住院费用下降11.72%，CEI从1.31降至1.06，TEI从0.74降至0.64。此外，DRGs数量从162增加到176，平均CMI值从0.80增至0.84，RW 1 - 5级病例比例增加。而且，手术病例数增加60.50%，微创手术增加53.54%，四级手术增加66.67%，进入临床路径的比例从77.76%增至86.64%。2021年5月至8月，内分泌亚专科收治率显著提高，DRGs数量呈上升趋势，CEI和TEI显著下降。2021年上半年，康复科、神经内科、肾病科、眼科及综合管理科糖尿病住院患者占比为21.99% - 38.54%。
DRGs工具可用于提高内分泌科临床诊疗能力，优化CEI、TEI、CMI及RW值。是新DRGs付费政策下促进内分泌科发展、在医院开展血糖管理、构建内分泌亚专科及提高手术和操作能力的有效途径。
