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《Soft Science of Health》 2017-10
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Application of DRGs in medical insurance payment management of ischemic cerebral infarction

CHEN Pei-ran;LIAO Zu-da;CHEN Shu;TENG Xiao-mei;SHAO Jian-hua;Affiliated Huashan Hospital of Fudan University;  
Objective To establish a scientific and precise DRGs medical insurance payment model for ischemic cerebral infarction. Formulate the standard of medical expense reimbursement and the threshold of exceeding standard cost. Methods We found the related factors that affected medical costs of ischemic cerebral infarction through interviewing experts. From 2014 to 2015,inpatient cases with urban medical insurance were collected from 10 three-level first class hospitals in Shanghai. Patients with ischemic cerebral infarction were divided into DRGs groups according to the method of decision tree. One way ANOVA and multiple linear regression were used to determine the main factors affecting the cost of hospitalization Results We established 7 DRGs hospitalization expense standard by treatment method,complications and NIHSS score. Conclusions DRGs grouping result can provide reference basis for the change of hospitalization expense payment mode and controlling hospitalization expenses.
【Fund】: 上海市卫生和计划生育委员会科研课题:精细化DRGs在缺血性脑梗死医保支付管理中的运用(201540325)
【CateGory Index】: F842.684;R197.1
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