Email Alert RSS
Volume 14 Issue 1
Jan.  2023
Turn off MathJax
Article Contents
Abstract
References
Related Articles
YANG Lang, WEI Junji, YIN Rui, WEN Junxian, CHANG Jianbo, CHEN Yihao, ZHANG Xiao, ZHANG Guojie, LI Chunhou, MA Wenbin, WANG Renzhi. Influencing Factors of Hospital Costs for Pituitary Tumor Under DRG Payment[J]. Medical Journal of Peking Union Medical College Hospital, 2023, 14(1): 148-152. DOI: 10.12290/xhyxzz.2022-0068
Citation: YANG Lang, WEI Junji, YIN Rui, WEN Junxian, CHANG Jianbo, CHEN Yihao, ZHANG Xiao, ZHANG Guojie, LI Chunhou, MA Wenbin, WANG Renzhi. Influencing Factors of Hospital Costs for Pituitary Tumor Under DRG Payment[J]. Medical Journal of Peking Union Medical College Hospital, 2023, 14(1): 148-152. DOI: 10.12290/xhyxzz.2022-0068
shu

Influencing Factors of Hospital Costs for Pituitary Tumor Under DRG Payment

  • 1.

    Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China

  • 2.

    Medical Department, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China

  • 3.

    Medical Insurance Office, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China

Funds: 

Beijing Tianjin Hebei Basic Research Cooperation Project 19JCZDJC64600(Z)

CAMS Innovation Fund for Medical Sciences 2020-I2M-C & T-B-028

Non-profit Central Research Institute Fund of CAMS 2020-JKCS-026

More Information
  • Corresponding author:

    WEI Junji, E-mail: weijj1999@163.com

  • Received Date: February 19, 2022
  • Accepted Date: March 29, 2022
  • Available Online: August 30, 2022
  • Issue Publish Date: January 29, 2023
    Graphical Abstract
    • Abstract
  •   Objective  To analyze the influencing factors of hospitalization expenses of patients treated in the KC19 group by the neurosurgery department of a tertiary hospital in Beijing, and provide reference for the refinement of diagnosis related groups(DRG).
      Methods  The medical records of 3809 patients from January 1, 2017 to November 30, 2021 were reviewed, and relevant influencing factors were determined using descriptive statistics, univariate analysis, and multivariate linear regression.
      Results  Among the 3809 patients included in this study, the average total hospitalization cost was 36 166.82 yuan, and the average hospital stay was 9.42 days. Neuroendoscopy accounted for 35.2%, while major complications or comorbidities (MCC) and complications or comorbidity (CC) accounted for 40%. Univariate analysis found that hospitalization costs were associated with gender, length of hospital stay, number of other diagnoses, number of surgical procedures, use of neuroendoscopy, and the presence of MCC or CC. Multivariate analysis found that the main influencing factors were the length of hospital stay, followed by the number of other diagnoses, the number of surgical operations, whether neuroendoscopy was used, whether there was MCC or CC, and gender.
      Conclusion  In the follow-up fine grouping of KC19, the above influencing factors should be considered, and the use of neuroendoscopy and the presence of MCC or CC should be included in the grouping criteria.
    • FullText(HTML)
    • References (15)
  • [1]
    国家医疗保障局. 关于印发疾病诊断相关分组(DRG)付费国家试点技术规范和分组方案的通知[EB/OL ]. (2019-10-24)[2022-08-26]. http://www.nhsa.gov.cn/art/2019/10/24/art_52_1875.html.
    [2]
    Daly AF, Beckers A. The Epidemiology of Pituitary Adenomas[J]. Endocrinol Metab Clin North Am, 2020, 49: 347-355. DOI: 10.1016/j.ecl.2020.04.002
    [3]
    国家医疗保障局. 医疗保障疾病诊断相关分组(CHS-DRG)细分组方案(1.0版)[EB/OL ]. (2020-06-18)[2022-08-26]. http://www.nhsa.gov.cn/art/2020/6/18/art_37_3240.html.
    [4]
    Lee CC, Kimmell KT, Lalonde A, et al. Geographic variation in cost of care for pituitary tumor surgery[J]. Pituitary, 2016, 19: 515-521. DOI: 10.1007/s11102-016-0738-x
    [5]
    李秀梅, 刘理, 胡海源, 等. DRG支付下脑卒中患者住院费用控制研究[J]. 卫生经济研究, 2022, 1: 44-47. https://www.cnki.com.cn/Article/CJFDTOTAL-WSJJ202201013.htm
    [6]
    Vaughan-Sarrazin M, Bayman L, Rosenthal G, et al. The business case for the reduction of surgical complications in VA hospitals[J]. Surgery, 2011, 149: 474-483. DOI: 10.1016/j.surg.2010.12.004
    [7]
    廖慧群, 麦紫娟, 廖彩霞. 收治病种结构对医院CMI值的影响[J]. 中国病案, 2022, 23: 10-12. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGBN202201005.htm
    [8]
    Institut für das Entgeltsystem im Krankenhaus. aG-DRG German Diagnosis Related Groups Version 2022 Definitionshandbuch Kompaktversion[EB/OL]. (2022-01-26)[2022-08-26]. https://www.g-drg.de/aG-DRG-System_2022/Definitionshandbuch/Definitionshandbuch_20222.
    [9]
    Centers for Medicare & Medicaid Services. ICD/-10-CM/PCS MS-DRG v39.1 Definitions Manual[EB/OL]. (2021-11-16)[2022-08-26]. https://www.cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0001.html.
    [10]
    Eseonu CI, ReFaey K, Garcia O, et al. Comparative Cost Analysis of Endoscopic versus Microscopic Endonasal Transsphenoidal Surgery for Pituitary Adenomas[J]. J Neurol Surg B Skull Base, 2018, 79: 131-138. DOI: 10.1055/s-0037-1604484
    [11]
    Ament JD, Yang Z, Khatchadourian V, et al. Cost-Effectiveness of Endoscopic Versus Microscopic Transsphenoidal Surgery for Pituitary Adenoma[J]. World Neurosurg, 2018, 110: e496-e503. DOI: 10.1016/j.wneu.2017.11.046
    [12]
    Jethwa PR, Patel TD, Hajart AF, et al. Cost-Effectiveness Analysis of Microscopic and Endoscopic Transsphenoidal Surgery Versus Medical Therapy in the Management of Microprolactinoma in the United States[J]. World Neurosurg, 2016, 87: 65-76. DOI: 10.1016/j.wneu.2015.10.090
    [13]
    Hardy J. Transphenoidal microsurgery of the normal and pathological pituitary[J]. Clin Neurosurg, 1969, 16: 185-217. DOI: 10.1093/neurosurgery/16.CN_suppl_1.185
    [14]
    Jankowski R, Auque J, Simon C, et al. Endoscopic pituitary tumor surgery[J]. Laryngoscope, 1992, 102: 198-202.
    [15]
    Tabaee A, Anand VK, Barrón Y, et al. Endoscopic pituitary surgery: a systematic review and meta-analysis[J]. J Neurosurg, 2009, 111: 545-554. DOI: 10.3171/2007.12.17635
    • Related Articles

  • Related Articles

    [1]CHENG Weishi, LIAN Xin, PANG Tingtian, ZHANG Yue, SUN Yuliang, LIU Zhikai. CyberKnife Stereotactic Radiosurgery System for Pituitary Tumors and Pulmonary Cancer Bone Metastases: Initiating a New Chapter in Stereotactic Radiotherapy[J]. Medical Journal of Peking Union Medical College Hospital. DOI: 10.12290/xhyxzz.2024-0324
    [2]WANG Aimin, CHEN Chaojin, WANG Mujun, WANG Ruhao, LYU Jingjing. Medical Expenses for Hospitalized Patients with Cervical Cancer Before and After the Implementation of the DRG Payment Policy[J]. Medical Journal of Peking Union Medical College Hospital, 2024, 15(5): 1077-1082. DOI: 10.12290/xhyxzz.2024-0475
    [3]WANG Yutong, ZHU Weiguo, SUN Xueqin, TONG Jiali, ZHOU Jingya, ZHAO Qing, LI Bocheng, ZHANG Wei, LIU Xiaokun, DONG Rui, XIE Chen, HAN Ding. Factors Influencing Inpatient Costs for Patients Undergoing Surgery for Intrauterine Lesions under DRG Payment[J]. Medical Journal of Peking Union Medical College Hospital, 2024, 15(5): 1069-1076. DOI: 10.12290/xhyxzz.2024-0375
    [4]YANG Shiming, SHEN Weidong, WU Nan. A Combined Transcranial-Transtemporal-Transcervical Approach to Complex Lateral Skull Base Tumors[J]. Medical Journal of Peking Union Medical College Hospital, 2021, 12(6): 840-843. DOI: 10.12290/xhyxzz.2021-0647
    [5]Hui-juan ZHU, Ren-zhi WANG. Clinical Diagnosis and Treatment of Pituitary Adenomas[J]. Medical Journal of Peking Union Medical College Hospital, 2020, 11(5): 533-536. DOI: 10.3969/j.issn.1674-9081.2020.05.007
    [6]Shi-yue LI, Wei DENG, Lei YANG, Qian LI. Value of Huaxi Emotional-distress Index for Evaluating the Length of Hospital Stay, Hospitalization Costs, and Patient Satisfaction in Elderly Patients after Surgery[J]. Medical Journal of Peking Union Medical College Hospital, 2020, 11(4): 414-419. DOI: 10.3969/j.issn.1674-9081.2020.04.010
    [7]Xi BAI, Hui-juan ZHU, Hui PAN. The Multidisciplinary Pituitary Team of Peking Union Medical College Hospital: 40 Years of Hard Work[J]. Medical Journal of Peking Union Medical College Hospital, 2020, 11(3): 334-338. DOI: 10.3969/j.issn.1674-9081.20200060
    [8]Ye-ye CHEN, Hong-sheng LIU, Shan-qing LI, Cheng HUANG, Li LI, Ying-zhi QIN. Neuroendocrine Tumors of the Thymus: Outcomes after Surgical Resection and Prognostic Factors[J]. Medical Journal of Peking Union Medical College Hospital, 2016, 7(3): 190-194. DOI: 10.3969/j.issn.1674-9081.2016.03.006
    [10]Xu TIAN, Guo-dong FENG, Hong JIANG, Wei Lü, Fang QI, Xiao-wei CHEN, Wu-yi LI, Zhi-qiang GAO. Surgical Treatment of Jugular Foramen Tumors[J]. Medical Journal of Peking Union Medical College Hospital, 2012, 3(2): 175-179. DOI: 10.3969/j.issn.1674-9081.2012.02.010

  • Cited by

    Periodical cited type(7)

    1. 王栎垚，毛国育. 公立A医院运用DRG对临床科室的运营管理研究. 医学信息. 2023(04): 52-56 .
    2. 李梦滢，顼晋昆，杨菁. 基于归纳法和专家咨询法的CHS—DRG合并症、并发症分组探索——以UPPP手术在DB33和DB35入组为例. 中国医疗保险. 2023(09): 86-93 .
    3. 曾凡伟，任国娇. DRG视角下北京市3次医改对冠心病介入患者住院费用的影响. 现代医药卫生. 2023(19): 3406-3410 .
    4. 宋康，刘新靓，罗小霞，张志彬，潘卫兵，李准，黎浩. 基于决策树模型的梗阻性肾盂积水患者住院费用及病例组合优化研究. 华西医学. 2023(10): 1530-1536 .
    5. 丁敬美，韩磊，杜进兵. 武汉市DRG入组病例的费用倍率特征分析. 卫生经济研究. 2023(12): 28-32 .
    6. 伍渊麟，刘耀，甘岚澜，向贵圆，李晨，陈世耕，鲜秋婉. DRG支付方式下EB19组胸部大手术患者住院费用的影响因素研究. 重庆医学. 2023(23): 3665-3668 .
    7. 聂晓静，付豪斐，白荷荷，李亚萍，王金萍. 糖尿病患者DRG分组效果及住院费用影响因素分析. 中国药房. 2023(24): 3020-3024 .

    Other cited types(1)

Catalog

    Get Citation
    PDF
    XML

    Article Metrics

    Article views (625) PDF downloads (84) Cited by(8)
    Related
    Links: National Health Commission of the People's Republic of China Chinese Academy of Medical Sciences(CAMS) AMLC Check CNKI Database CNKI Term Online Chinese General Practice
    Address：Room 302,Third Floor,Building 7, No. 1 Shuaifuyuan, Wangfujing, Dongcheng District, Beijing 100730, China
    Tel：010-69154261/4262
    E - mail：medj@pumch.cn mjpumch@126.com
    Copyright of website：Editorial Office of Medical Journal of Peking Union Medical College Hospital

    Supported by: Beijing Renhe Information Technology Co., Ltd.  Baidu Analytics

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return
    x Close Forever Close