Ortega-Moreno A, Martínez-Tapia J, Pérez-Sáez F
Servicio de Neurología, Hospital Universitario Virgen de las Nieves, Granada, España.
Rev Neurol. 1998 Sep;27(157):453-8.
The influence on health costs of variations in the clinical practice of doctors makes it necessary for them to be involved in the administration of resources so as to increase the efficacy, effectiveness and efficiency of clinical units.
To analyze the activity of the Neurology Department of the Virgen de las Nieves Hospital of Granada and to determine its costs per GRD.
Activity during 1996 was compared with that of the previous year and with a standard using measurements of cases, efficiency in administration of beds, quality of data and quality of care. The GRD costs of the service were found.
Ninety percent of the discharges were grouped in 20 GRD, and GRD 014 and 015 represented 44% of the productivity. Complexity of the cases was 5% more than in 1995, similar to that of Rule IV [20]. Extreme cases led to a third of all admissions. Mortality was less than expected (3.13%). Hospital stays made up 82% of the total cost. The cost of one stay in hospital was 463.686 pesetas.
It is essential to improve the structure and procedures related to hospital care of patients with cerebral vacular pathology. Those with uncomplicated conditions should be attended as outpatients or in smaller hospitals. The GRD costs obtained are not comparable to those of other authors. Hospital activity should be measured homogeneously and use should be made of analytical accounting systems with common operators and standardized applications so as to obtain reliable, comparable data.
医生临床实践的差异对医疗成本产生影响，这使得他们有必要参与资源管理，以提高临床科室的效能、效果和效率。
分析格拉纳达圣母雪医院神经科的活动，并确定其每GRD的成本。
将1996年的活动与上一年的活动以及使用病例测量、床位管理效率、数据质量和护理质量的标准进行比较。找出该服务的GRD成本。
90%的出院病例归为20个GRD，GRD 014和015占生产力的44%。病例的复杂性比1995年高5%，与规则IV [20]相似。极端病例占所有入院病例的三分之一。死亡率低于预期（3.13%）。住院天数占总成本的82%。一次住院的成本为463.686比塞塔。
改善与脑血管疾病患者医院护理相关的结构和程序至关重要。病情不复杂的患者应作为门诊患者或在较小的医院接受治疗。所获得的GRD成本与其他作者的成本不可比。医院活动应以统一方式进行衡量，并应使用具有通用操作员和标准化应用程序的分析会计系统，以获得可靠、可比的数据。
