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Disease composition book accounting method based on DRGs

A cost and disease type technology, applied in the field of disease group cost accounting based on DRGs, can solve the problems of lack of motivation for disease cost management, no disease group cost accounting method, conflict of medical insurance pricing models, etc., to achieve timeliness The effect of remarkable features, low implementation threshold and strong operability

Pending Publication Date: 2021-10-29
XIN HUA HOSPITAL AFFILIATED TO SHANGHAI JIAO TONG UNIV SCHOOL OF MEDICINE
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  • Abstract
  • Description
  • Claims
  • Application Information

AI Technical Summary

Problems solved by technology

[0003] ① As the provider of medical services, public hospitals lack the motivation to actively carry out disease cost management based on DRGs because they do not have independent pricing power
[0004] ②At present, there is no suitable method for cost accounting based on disease group
[0005] ③ From the perspective of the payer of medical services (mainly the medical insurance fund), there is a conflict between the pricing of diseases based on DRGs and the existing pricing model of medical insurance
"Diagnosis Related Groups (DRGs) payment" is a new entry point for the reform of medical insurance payment methods in my country, but there is currently no suitable cost accounting method for disease groups

Method used

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  • Disease composition book accounting method based on DRGs
  • Disease composition book accounting method based on DRGs
  • Disease composition book accounting method based on DRGs

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Experimental program
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specific Embodiment approach

[0046]Specific implementation methods: All 112,305 hospitalized cases in 2017 were derived from the sample hospital medical record information system as the basic sample. The key fields include the main diagnosis code, the name of the main diagnosis, and the cost details on the first page of the medical history, etc., as follows:

[0047] Table 2 The main key fields of information export on the first page of the medical record

[0048]

[0049] All 112,305 hospitalized cases exported from the information system on the front page of medical records will serve as the basis for subsequent work such as grouping of diseases. Therefore, whether the information registration on the front page of medical records is standardized and complete will directly affect the subsequent grouping results of DRGs.

[0050] (2) Division of disease groups and group units

[0051] ①Grouper selection

[0052] DRGs case grouping is the basis for implementing DRGs cost accounting. In recent years,...

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Abstract

The invention discloses a disease composition book accounting method based on DRGs. The method comprises the steps: determining a service unit by taking the first page cost record of a patient case as a blue book, comparing the cost of the service unit with the actual cost to determining a cost-expense ratio value; and under the condition that the cost-expense ratio is assumed to be relatively fixed, according to the DRGs grouping condition of the patient, calculating the process of the disease category composition in a certain time period. The method is high in operability and has corresponding popularization value; the accounting result is accurate; and the actual requirements of internal management can be met.

Description

technical field [0001] The invention relates to a cost accounting method for disease groups based on DRGs. Background technique [0002] Application Status and Existing Problems [0003] ① As the provider of medical services, public hospitals lack the motivation to actively carry out disease cost management based on DRGs because they do not have independent pricing power. [0004] ②At present, there is no suitable cost accounting method based on disease group. [0005] ③ From the perspective of the payer of medical services (mainly the medical insurance fund), there is a conflict between the pricing of diseases based on DRGs and the existing pricing model of medical insurance. [0006] ④ There are other bottlenecks in the implementation of payment by disease group. [0007] In addition to the above-mentioned factors, the non-unified system of disease classification and diagnosis codes, surgery and operation codes, non-standard clinical pathways, large differences in disea...

Claims

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Application Information

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IPC IPC(8): G06Q30/02G16H50/70
CPCG06Q30/0206G06Q30/0283G16H50/70
Inventor 刘雅娟孙锟唐国瑶宋雄程明黄玲萍陈冲
Owner XIN HUA HOSPITAL AFFILIATED TO SHANGHAI JIAO TONG UNIV SCHOOL OF MEDICINE