论坛Jospital医皖管理论坛河南省某三甲医院肾内科DIP付费制度实施情况分析AnalysisofImplementationofDIPPaymentinNephrologyDepartmentofaTertiaryHospitalinHenanProvince李鑫LIXin陈献振CHENXian-zhen王莹莹WANGYing-ying许丹XUDan滕俊玲TENGJun-ling摘要Abstract目的探讨河南省某三甲医院肾内科2020一2022年出院病历优势病种和手术操作组合，分析该科室DIP付费制度实施情况。方法提取2020一2022年肾内科出院病历病案首页基本信息数据进行描述性分析，采用x检验、Fisher's确切概率法比较分析不同年份手术操作率的差异、不同年份出院病历治疗效果的差异。结果该院肾内科前6位病种为慢性肾脏病5期贫血、肾病综合征伴膜性肾小球肾炎、慢性肾脏病5期、肾病综合征、人工动静脉痿狭窄和狼疮性肾炎；与前两年相比，2022年肾内科出院病历前3位病种7组病种组合中6组次均费用均降低；前6位病种中4个病种在3年间的手术操作占比差异有统计学意义(p<0.05)，且2022年手术操作率均为最高；2020一2022年间出院病历主要诊断治愈/好转率逐渐上升。结论DIP付费制度的实施降低了医疗费用，减轻了患者疾病负担，提升了临床诊治能力，协助推动了医疗机构精益运营管理模式的建立。ObjectiveToexplorethedominantdiseasesandsurgicaloperationcombinationsinthedischargemedicalrecordsofthenephrologydepartmentofatertiaryhospitalinHenanProvincefrom2020to2022,andtoanalyzeitsimplementationofDIPpaymentsystem.MethodsThebasicinformationofthefrontsheetofdischargemedicalrecordsofthenephrologydepartmentfrom2020to2022wereextractedfordescriptiveanalysis.XtestandFisher'sexactprobabilitymethodwereusedtocompareandanalyzethedifferencesinsurgicaloperationrateandtreatmenteffectofdischargemedicalrecordsindifferentyears.ResultsThetopsixdiseasesinthenephrologydepartmentofthehospitalwereanemiaofchronickidneydiseasestage5,nephroticsyndromewithmembranousglomerulonephritis,chronickidneydiseasestage5,nephroticsyndrome,artificialarteriovenousfistulastenosisandlupusnephritis.Comparedwiththeprevioustwoyears,theaveragecostpervisitof6groupsof7diseasecombinationsofthetop3diseasesinnephrologydischargerecordsin2022decreased.Fourofthetopsixdiseaseshadstatisticallysignificantdifferencesintheproportionofsurgicaloperati...
