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目的:探讨膝关节置换术患者总费用的影响因素,为有效控制膝关节置换术患者住院费用提供参考依据。方法:采用疾病诊断相关组(Diagnosis related groups,DRG)方法根据患者的伴发症数目将患者分为6组,根据年龄将患者分为2组,分析不同分组患者膝关节置换费用的差异。结果:不同伴发症数目的患者总费用差异不具有统计学意义,卡方值=3.558,P=0.615,但膝关节置换术患者伴发症在0~4种时,随着伴发症的增多,总费用呈现上升的趋势;不同年龄组的患者总费用差异不具有统计学意义,统计量为-1.763,P=0.078,年龄<70岁膝关节置换术患者总费用中位数高于年龄≥70岁。结论:膝关节置换术患者涉及多种伴发症、不同年龄时,按病种付费与DRGs支付基本一致。提示当病情相对复杂时医院医保部门可向医保中心申请把单病种限额结算的病种转为普通病种定额结算,医院应对符合单病种核算的病种病例制定单病种诊疗流程或临床路径来缩短平均住院日、降低医疗费用,以应对单病种限额结算这种支付模式。
Objective: To study the influencing factors of the total cost of patients undergoing knee arthroplasty and to provide a reference for effective control of hospitalization costs in patients undergoing knee arthroplasty. Methods: The patients were divided into 6 groups according to the number of patients’ complication by using the method of diagnosis related groups (DRG). The patients were divided into two groups according to the age, and the difference of knee replacement cost was analyzed. Results: There was no significant difference in the total cost of patients with different complication rates, with a chi square value of 3.558 and P = 0.615. However, patients with knee arthroplasty had 0 to 4 complications, Increase, the total cost showed an upward trend; the total cost of patients in different age groups was not statistically significant, the statistics was -1.763, P = 0.078, the median total cost of knee replacement patients aged <70 years was higher than the age ≥70 years old. CONCLUSIONS: Patients with knee arthroplasty are involved in a number of complication events. At different ages, payment by illness and DRGs are basically consistent. Prompt when the condition is relatively complex when the hospital medical insurance department can apply to the Medicare Center to limit the settlement of single disease limit to common disease fixed settlement, the hospital should be consistent with the single disease accounting for the development of single disease case diagnosis and treatment process or clinical Path to shorten the average length of stay, reduce medical costs, in order to cope with the single disease limit settlement of this payment model.