基于DRG医保付费的手术病种临床路径精益化管理效果研究

doi:10.20047/j.issn1673-7210.2023.16.36

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Abstract Objective To explore the effect of lean management (LM) on clinical pathway (CP) of surgical diseases under the background of medical insurance payment reform of diagnosis related groups(DRG). Methods Taking 13 surgical diseases under CP management in ethnic hospitals of Guangxi Zhuang Autonomous Region as the research object, 2020 (before LM application) as the control group, 2021 (after LM application) as the experimental group, the improvement of core indicators were compared, and the implementation effect of LM in surgical diseases CP was evaluated. Results The completion rate of the experimental group was 87.42% and that of the control group was 84.14%. The completion rates of laparoscopic appendectomy, ureteroscope pneumatic lithotripsy, breast benign tumor resection, coronary artery stenting, and carotid artery stenting in the experimental group were higher than those in the control group, and the differences were statistically significant (P＜0.05). The mutation completion rate was 19.37% in the experimental group and 21.77% in the control group. Laparoscopic hysterectomy, laparoscopic appendectomy, endoscopic colorectal polypectomy, endoscopic thyroidectomy, coronary artery stenting, and carotid artery stenting in the experimental group were lower than those in the control group, with statistical significances (P＜0.05). The incidence of surgical complications was 2.60% in the experimental group and 3.33% in the control group. The complication rates of laparoscopic subtotal hysterectomy, laparoscopic appendectomy, endoscopic colorectal polypectomy, subtotal thyroidectomy and coronary stenting in the experimental group were lower than those in the control group, and the differences were statistically significant (P＜0.05). The average hospital stay and average preoperative hospital stay of most diseases were lower than those of control group, and the differences were statistically significant (P＜0.05). In the experimental group, average hospitalization cost, average drug cost and average consumables cost were decreased in different degrees, the differences were statistically significant (P＜ 0.05). Conclusion LM has a significant improvement effect on CP management of surgical diseases, can effectively improve the total number of surgical diseases, efficiency, benefit and quality indicators, and improve the level of hospital disease management.

Key words： Lean management Clinical pathway Diagnosis related groups Surgical diseases Medical insurance payment reform

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	MO Xiali1 HE Huimin2

Cite this article:

MO Xiali1 HE Huimin2. Research on the effect of lean management of clinical pathway of surgical diseases base on DRG medical insurance payment[J]. 中国医药导报, 2023, 20(16): 162-167.

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https://www.yiyaodaobao.com.cn/EN/10.20047/j.issn1673-7210.2023.16.36 OR https://www.yiyaodaobao.com.cn/EN/Y2023/V20/I16/162

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