Volume 14 Issue 1
Jan.  2023
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Article Contents
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

Influencing Factors of Hospital Costs for Pituitary Tumor Under DRG Payment

doi: 10.12290/xhyxzz.2022-0068
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: 2022-02-20
  • Accepted Date: 2022-03-30
  • Available Online: 2022-08-31
  • Publish Date: 2023-01-30
  •   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.
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  • [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
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