Comparative analysis of hospitalization expenses and structure of day surgery diseases between general hospital and traditional Chinese medicine hospital_West China Medical Journal

Authors：

YANG Jialin ^1,2 ,  YANG Wei ^2,3 , ZHONG Liwei ^2,4 , JIN Wenqi ⁵ , SHEN Ting ^2,3

1. Department of Medical Affairs, Renji Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200127, P. R. China;
2. Disease Quality and Safety Research Center of Municipal Hospital, Shanghai Hospital Development Center, Shanghai 200071, P. R. China;
3. Department of Medical Affairs, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai 200071, P. R. China;
4. Office of Director, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai 200071, P. R. China;
5. Department of Proctology, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai 200071, P. R. China;

Corresponding?author：

YANG Wei, Email: 13917475246@163.com

Keywords：

Day surgery; general hospital; traditional Chinese medicine hospital; hospitalization expenses

DOI：

10.7507/1002-0179.202211091

Video：

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Objective To analyze the hospitalization expenses and structure of day surgery diseases between general hospital and traditional Chinese medicine hospital, so as to provide a basis for the reform policy formulation of the payment mode of traditional Chinese medicine medical insurance and the optimization of hospital management. Methods Relevant data such as hospitalization expenses and expenses structure of day surgery of one general hospital and one traditional Chinese medicine hospital in Shanghai between January 1, 2019 and June 30, 2022 were selected. The hospitalization expenses and expenses structure of day surgery in traditional Chinese medicine hospital and general hospital were analyzed. Results A total of 95232 day surgery cases were selected in the case hospitals, including 1389 cases in traditional Chinese medicine hospital and 93843 cases in general hospital. The age of day surgery patients in traditional Chinese medicine hospital was smaller than that in general hospital (P<0.001). The total hospitalization expenses [4379.6 (2293.2, 7563.4) vs. 7629.5 (4467.5, 14154.0) yuan], drug expenses [343.0 (65.0, 1107.0) vs. 749.0 (64.0, 1419.0) yuan], consumables expenses [858.8 (162.2, 1630.1) vs. 1951.0 (620.1, 5720.7) yuan], technical labor expenses [1994.8 (1116.8, 3252.4) vs. 3943.3 (2510.8, 6123.4) yuan] of day surgery patients in traditional Chinese medicine hospital were lower than those of patients in general hospital (P<0.001), and the examination expenses were higher than those of patients in general hospital [432.0 (0.0, 898.5) vs. 40.0 (0.0, 418.0) yuan, P<0.001]. In terms of the total hospitalization expenses structure of patients undergoing day surgery, the proportion of technical labor expenses in traditional Chinese medicine hospital was the highest (42.5%), and the proportion of consumables expenses in general hospital was the highest (43.7%). The specialty of day surgery in the traditional Chinese medicine hospital mainly focused on gynecology, general surgery, anorectal surgery and pain medicine, with the highest average expenses in ophthalmology. The specialty of day surgery in the general hospital mainly focused on urology, biliary, pancreatic and gastrointestinal surgery, ophthalmology and gynecolog, with the highest average expenses in orthopedics. There was no statistically significant difference between the age of patients undergoing hemorrhoidectomy in traditional Chinese medicine hospital and that in general hospital (P>0.05). The total hospitalization expenses [7177.4 (6057.5, 8225.7) vs. 10730.3 (8895.7, 14291.4) yuan], drug expenses [838.0 (441.0, 1342.0) vs. 1532.0 (1335.0, 1698.0) yuan], consumables expenses [4518.7 (4268.3, 5084.9) vs. 5550.9 (4066.6, 8340.7) yuan], technical labor expenses [1138.8 (911.3, 1414.2) vs. 3793.9 (2997.1, 4410.3) yuan] of day surgery patients undergoing hemorrhoidectomy in traditional Chinese medicine hospital were lower than those of patients in general hospital (P<0.05), and the examination expenses were higher than those of patients in general hospital [329.0 (0.0, 598.0) vs. 40.0 (40.0, 40.0) yuan, P<0.05]. In terms of the total hospitalization expenses structure of day surgery patients undergoing hemorrhoidectomy, the highest proportion was consumables expenses both in traditional Chinese medicine hospital and general hospital (63.8% and 53.6%, respectively). Conclusions There are differences between the hospitalization expenses of day surgery in traditional Chinese medicine hospital and general hospital. The dominant disease types of day surgery in traditional Chinese medicine hospitals need to be further cultivated. In the future, when the traditional Chinese medicine medical institutions implement the payment according to the diagnosis-related group/diagnosis-intervention packet, they should fully combine the actual situation of the medical institutions and the characteristics of the disease type, and at the same time, they need to further establish the medical fine management based on the disease type quality evaluation.

Citation： YANG Jialin, YANG Wei, ZHONG Liwei, JIN Wenqi, SHEN Ting. Comparative analysis of hospitalization expenses and structure of day surgery diseases between general hospital and traditional Chinese medicine hospital. West China Medical Journal, 2023, 38(2): 220-225. doi: 10.7507/1002-0179.202211091 Copy

1.	國家醫療保障局. 國家醫療保障局關于印發 DRG/DIP 支付方式改革三年行動計劃的通知. (2021-11-19)[2022-11-14]. http://www.gov.cn/zhengce/zhengceku/2021-11/28/content_5653858.htm.
2.	國家醫療保障局, 國家中醫藥管理局. 國家醫療保障局國家中醫藥管理局關于醫保支持中醫藥傳承創新發展的指導意見. (2021-12-14)[2022-11-14]. http://www.gov.cn/zhengce/zhengceku/2022-01/01/content_5665996.htm.
3.	李芬, 王瑾, 陳多, 等. 建立符合中醫藥服務運行特點的中醫醫院補償機制. 中國衛生政策研究, 2016, 9(4): 44-48.
4.	馬忠凱, 欒瑞, 肖平, 等. 中醫醫院重點科室 DRG 疾病編碼常見問題探討. 中國衛生經濟, 2020, 39(12): 93-95.
5.	王靜, 鐘力煒, 言行, 等. 上海市中醫醫院醫保支付改革實踐探索. 中國醫院管理, 2022, 42(3): 70-73.
6.	朱小穎, 田侃, 方鵬騫, 等. 我國中醫醫院 DRG 付費若干問題與對策探討. 中國醫院, 2022, 26(5): 10-12.
7.	肖祖林, 彭立生, 任真, 等. 基于慢性乙型肝炎的中成藥應用現狀探討 DRGs 付費制度下中成藥存在的問題及對策. 中國醫藥指南, 2018, 16(19): 14-16.
8.	劉黎明, 邱佳瑜, 宣天惠, 等. 中醫優勢病種在綜合醫院和中醫類醫院住院費用對比分析. 中國衛生經濟, 2022, 41(7): 24-27.
9.	潘佳佳, 王長青, 張文良, 等. 價值醫療視角下中醫醫院 DRG 綜合運營管理方案探索. 中國衛生經濟, 2021, 40(6): 77-81.
10.	中華醫學會外科學分會結直腸肛門外科學組, 中華中醫藥學會肛腸病專業委員會, 中國中西醫結合學會結直腸肛門病專業委員會. 痔臨床診治指南(2006 版). 中華胃腸外科雜志, 2006, 9(5): 461-463.
11.	杜奕, 俞華, 傅春瑜, 等. 日間手術信息管理平臺建設探討. 華西醫學, 2019, 34(2): 116-121.
12.	趙蓉, 楊麗, 張薇薇, 等. 上海市級醫院日間手術發展現狀評估. 中國醫院, 2015(4): 7-9.
13.	陳建平, 趙蓉, 楊麗, 等. 上海市級醫院日間手術發展的實踐與思考. 中國醫院, 2015(4): 1-2.
14.	陳希琳, 陳朝文, 段宏巖, 等. 痔診療日間手術專家共識(2020 年版). 實用臨床醫藥雜志, 2020, 24(10): 1-8.
15.	楊海豐, 崔志偉, 王茂, 等. 我國中醫優勢病種分布狀況及特點. 中醫雜志, 2012, 53(4): 285-287.
16.	謝俊明, 章琦琴, 王鐘炎, 等. 中醫藥服務醫保支付方式及標準的思考. 中國醫療保險, 2017(7): 51-53.
17.	袁素維, 劉燕, 朱建征, 等. 我國醫保支付方式改革的有效性邊界研究. 中國衛生政策研究, 2018, 11(9): 24-27.
18.	王琨, 蔣雷, 張燦宏, 等. 基于 DRGs 的臨床路徑住院費用分析. 中國衛生質量管理, 2019, 26(4): 28-30.
19.	金麗霞, 劉毅, 劉斌. 基于專科醫院某疾病診斷相關分組費用分析的管理思路探討. 華西醫學, 2019, 34(12): 1379-1383.
20.	蘇里皮哈·帕爾哈提, 劉庭芳. “醫院基于價值購買”支付項目的特點及借鑒. 中國醫院, 2019, 23(6): 66-68.

1. 國家醫療保障局. 國家醫療保障局關于印發 DRG/DIP 支付方式改革三年行動計劃的通知. (2021-11-19)[2022-11-14]. http://www.gov.cn/zhengce/zhengceku/2021-11/28/content_5653858.htm.
2. 國家醫療保障局, 國家中醫藥管理局. 國家醫療保障局國家中醫藥管理局關于醫保支持中醫藥傳承創新發展的指導意見. (2021-12-14)[2022-11-14]. http://www.gov.cn/zhengce/zhengceku/2022-01/01/content_5665996.htm.
3. 李芬, 王瑾, 陳多, 等. 建立符合中醫藥服務運行特點的中醫醫院補償機制. 中國衛生政策研究, 2016, 9(4): 44-48.
4. 馬忠凱, 欒瑞, 肖平, 等. 中醫醫院重點科室 DRG 疾病編碼常見問題探討. 中國衛生經濟, 2020, 39(12): 93-95.
5. 王靜, 鐘力煒, 言行, 等. 上海市中醫醫院醫保支付改革實踐探索. 中國醫院管理, 2022, 42(3): 70-73.
6. 朱小穎, 田侃, 方鵬騫, 等. 我國中醫醫院 DRG 付費若干問題與對策探討. 中國醫院, 2022, 26(5): 10-12.
7. 肖祖林, 彭立生, 任真, 等. 基于慢性乙型肝炎的中成藥應用現狀探討 DRGs 付費制度下中成藥存在的問題及對策. 中國醫藥指南, 2018, 16(19): 14-16.
8. 劉黎明, 邱佳瑜, 宣天惠, 等. 中醫優勢病種在綜合醫院和中醫類醫院住院費用對比分析. 中國衛生經濟, 2022, 41(7): 24-27.
9. 潘佳佳, 王長青, 張文良, 等. 價值醫療視角下中醫醫院 DRG 綜合運營管理方案探索. 中國衛生經濟, 2021, 40(6): 77-81.
10. 中華醫學會外科學分會結直腸肛門外科學組, 中華中醫藥學會肛腸病專業委員會, 中國中西醫結合學會結直腸肛門病專業委員會. 痔臨床診治指南(2006 版). 中華胃腸外科雜志, 2006, 9(5): 461-463.
11. 杜奕, 俞華, 傅春瑜, 等. 日間手術信息管理平臺建設探討. 華西醫學, 2019, 34(2): 116-121.
12. 趙蓉, 楊麗, 張薇薇, 等. 上海市級醫院日間手術發展現狀評估. 中國醫院, 2015(4): 7-9.
13. 陳建平, 趙蓉, 楊麗, 等. 上海市級醫院日間手術發展的實踐與思考. 中國醫院, 2015(4): 1-2.
14. 陳希琳, 陳朝文, 段宏巖, 等. 痔診療日間手術專家共識(2020 年版). 實用臨床醫藥雜志, 2020, 24(10): 1-8.
15. 楊海豐, 崔志偉, 王茂, 等. 我國中醫優勢病種分布狀況及特點. 中醫雜志, 2012, 53(4): 285-287.
16. 謝俊明, 章琦琴, 王鐘炎, 等. 中醫藥服務醫保支付方式及標準的思考. 中國醫療保險, 2017(7): 51-53.
17. 袁素維, 劉燕, 朱建征, 等. 我國醫保支付方式改革的有效性邊界研究. 中國衛生政策研究, 2018, 11(9): 24-27.
18. 王琨, 蔣雷, 張燦宏, 等. 基于 DRGs 的臨床路徑住院費用分析. 中國衛生質量管理, 2019, 26(4): 28-30.
19. 金麗霞, 劉毅, 劉斌. 基于專科醫院某疾病診斷相關分組費用分析的管理思路探討. 華西醫學, 2019, 34(12): 1379-1383.
20. 蘇里皮哈·帕爾哈提, 劉庭芳. “醫院基于價值購買”支付項目的特點及借鑒. 中國醫院, 2019, 23(6): 66-68.

West China Medical Journal

Comparative analysis of hospitalization expenses and structure of day surgery diseases between general hospital and traditional Chinese medicine hospital

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