文献类型：期刊文献

中文题名：我国DRG/DIP支付方式改革对患者住院费用影响的meta分析

英文题名：Meta-analysis of the Effect of DRG/DIP Payment Reform on Inpatient Costs in China

作者：宋金霞[1];化得良[2];沈裴汉[3];李祉睿[4];栗梦婷[4];张维[4]

第一作者：宋金霞

机构：[1]甘肃中医药大学公共卫生学院,甘肃兰州730000;[2]甘肃中医药大学附属医院发展与规划部,甘肃兰州730000;[3]甘肃省人民医院医保处,甘肃兰州730000;[4]甘肃中医药大学卫生管理学院,甘肃兰州730000

第一机构：甘肃中医药大学公共卫生学院

年份：2025

卷号：38

期号：6

起止页码：114

中文期刊名：医学与社会

外文期刊名：Medicine and Society

收录：;北大核心:【北大核心2023】；

基金：国家中医药管理局监测统计中心2024年度深化医改中医药政策研究课题,编号为YGZXKT2024368;甘肃省科技厅基础处立项项目,编号为23JRRA1197;甘肃省人民医院院内科研项目,编号为23GSSYC-9。

语种：中文

中文关键词：医保支付方式改革;DRG;DIP;住院费用

外文关键词：Health Insurance Payment Reform;DRG;DIP;Hospitalization Expense

摘要：目的:通过meta分析探讨我国DRG/DIP支付方式改革对患者住院费用的影响,为我国支付方式改革提供科学依据和决策支持。方法:检索Web of Science、PubMed、Embase、知网、万方、维普、中国生物医学数据库,检索时间为2009年1月1日至2023年12月31日,收集DRG/DIP支付方式改革对住院费用影响的实证研究文献。根据纳入排除标准筛选并提取数据,采用非随机对照试验方法学评价指标MINORS对研究质量进行评估。使用RevMan 5.4进行meta分析。结果:共纳入27篇研究。meta分析结果显示,实施DRG/DIP组与未实施组相比,住院总费用、床位费、检查费、化验费、手术费、药品费和一般诊疗费下降(P<0.05),医保基金补偿费用增加(P=0.03),个人支付费用、诊察费、治疗费、护理费、卫生材料费及综合医疗费的差异无统计学意义(P>0.05)。结论:DRG/DIP支付方式改革的实施能够降低患者住院费用,使费用结构进一步优化,但部分能体现医务人员劳动价值的费用未受影响,同时在个人支付费用未变的情况下医保基金补偿费用增加,可能会为医保基金的运行带来压力。后续工作的重点应是优化DRG/DIP分组体系、关注医务人员价值体现、加强监管和评估。
Objective:Through meta-analysis,this study explores the impact of the reform of DRG/DIP payment methods in China on patients'hospitalization expenses,providing scientific basis and decision support for the reform of payment methods in our country.Methods:We retrieved literature from Web of Science,PubMed,Embase,CNKI,Wanfang,VIP,and the China Biomedical Database,with a time limit of January 1,2009,to December 31,2023,to collect the empirical research literature on the impact of DRG/DIP payment reform on hospitalization costs.Data were screened and extracted according to inclusion and exclusion criteria.The methodological evaluation index MINORS for non-randomized controlled trials was used to assess the quality of the studies,and RevMan 5.4 was used for meta-analysis.Results:A total of 27 studies were included.The meta-analysis results showed that compared with the non-DRG/DIP group,the total hospitalization costs,bed costs,examination costs,laboratory costs,surgical costs,medication costs,and general diagnosis and treatment costs decreased(P<0.05),while the medical insurance fund compensation costs increased(P=0.03).There was no statistically significant difference in personal payment costs,consultation fees,treatment fees,nursing fees,health material fees,and comprehensive medical expenses(P>0.05).Conclusion:The implementation of DRG/DIP payment method reform can reduce patients'hospitalization expenses and further optimize the cost structure.However,some fees that reflect the value of medical staff's labor are unaffected.Meanwhile,the increase in medical insurance fund compensation costs without a change in personal payment may bring pressure to the operation of the medical insurance fund.The focus of subsequent work should be on optimizing the DRG/DIP grouping system,paying attention to the value reflection of medical staff,and strengthening supervision and evaluation.