Development and preliminary application of network-structured clinical pathway grouping rule based on CHS-DRG
10.3760/cma.j.cn111325-20241217-01064
- VernacularTitle:基于CHS-DRG的路网化临床路径分组规则的构建及应用初探
- Author:
Lina QU
1
;
Hui XU
;
Li XU
;
Kun XIONG
;
Suqing GOU
;
Aishu DONG
;
Wei LIN
;
Mingdong LU
Author Information
1. 温州医科大学附属第二医院质量管理部，温州 325024
- Publication Type:Journal Article
- Keywords:
Clinical pathway;
China healthcare security diagnosis related groups;
Network-structured;
Grouping rule;
Management framework;
Diagnosis related groups
- From:
Chinese Journal of Hospital Administration
2025;41(6):420-425
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To develop a network-structured clinical pathway grouping rule based on the principles and methods of China healthcare security diagnosis related groups(CHS-DRG), for references for optimizing clinical pathway management.Methods:From August to November 2024, this study constructed a network-structured clinical pathway management framework, followed the grouping principles of CHS-DRG, and developed a network-structured clinical pathway grouping rule through literature analysis and expert discussions. 54 clinical specialists from the sample hospital were organized and grouped according to the rule for the normal magnification cases(139 218 cases) of DRG medical insurance settlement in the hospital in 2023. Using a stratified random sampling method, 205 physicians from 54 clinical specialties in the hospital were selected to quantitatively evaluate the rationality, homogeneity, and clarity of the grouping results. The Likert 5-level scoring method was wsed to assign scores.Results:The network-structured clinical pathway grouping rule and nomenclature was established. A total of 341 main pathways and 35 sub-pathways covering 169 adjacent diagnosis related groups were formed. The quantitative assessment scores for rationality, homogeneity, and clarity were 4.90, 4.87 and 4.87 points, respectively.Conclusions:The network-structured clinical pathway grouping rule based on CHS-DRG had good, feasibility and standardization, and could meet the practical needs of clinical applications.
