Analysis on the operation of DRGs pilots in Yulin city of Shaanxi province
10.3760/cma.j.issn.1000-6672.2017.10.001
- VernacularTitle:陕西省榆林市DRGs付费试点运行情况分析
- Author:
Bin CUI
1
;
Zhaofang ZHU
;
Bingsheng XUE
;
Haijun HAN
;
Jing GAO
;
Lusheng WANG
Author Information
1. 100191,北京大学公共卫生学院
- Keywords:
New rural cooperative medical system;
Diagnosis-related groups;
Payment reform;
Operation analysis
- From:
Chinese Journal of Hospital Administration
2017;33(10):721-724
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the operation of the diagnosis-related groups ( DRGs) pilots for inpatients in the new rural cooperative medical system in Yulin city of Shaanxi province. Methods The medical records of 33306 inpatients discharged from the 3 pilot hospitals between January and July in 2017 were analyzed, aided by expert discussions, on-site assessment and medical records examinations. Results By the end of July 2017, the DRGs grouping tool had been running stably. The DRGs enrollment rates of discharged inpatients were all up to 99% in the 3 pilot hospitals. The coefficient of variation ( CV) was higher than 1 only in a few DRGs. The average length of stay and the average hospitalization expenses growth rate were both found declined. However, there also exist problems in the pilots, namely incomplete regulations for DRGs, low clinical path coverage rate, hysteretic supervision and assessment, uneven quality of medical records management and so on. Conclusions The pilots operated smoothly as evidenced in their initial success. Yet the following recommendations were raised for the improvements: To strengthen the organization and leadership to improve the DRGs related supporting system in pilot hospitals; To strengthen the promotion and application of clinical paths for standardization of the medical service process;To improve the DRGs assessment program and establish DRGs operation monitoring and tracking analysis system; To strengthen the training of medical record coding staff to improve continuously the quality of medical records.
