医院内病种费用控制标准的制定

目的：建立医院内病种费用的控制标准.方法：对医院病案首页数据库中3年的数据进行预处理并贴现，根据病例分型的思想，按照病人入院状态分为4种类型。对每一类型的平均住院日、医疗总费用和药品费用数据进行正态性检验，计算每一类型的平均住院日、医疗总费用和药品费用的均数和上、下限。再采用Delphi法对初步筛选结果由临床医学专家进行评价与筛选。结果：以中位数作为平均住院日、医疗总费用和药品费用的均值，以上四分位数和下四分位数作为控制的上限和下限，确定759个病种、136种类型作为医院费用控制的常见病种。并可根据医疗费用和药品费用的增长幅度确定每年度医疗总费用和药品费用的控制标准和上下限。结论：为保证样本含量，医院内宜采取病种分型的方法确定病种，以中位数作均数，以上、下四分位数作为控制的上、下限。

The Formulation of Expenditure Control Criteria forClassification Based on Diagnosis in Hospital

Objective To formulate the expenditure control criteria for cases in hospital. Methods Three years data are selected from case records' database and are pretreatmented and discounted. The cases are classified four types by the idea of Classification of Cases. To have a normal distribution test with days,total and drug expenditure in each type and calculate their median and QU and QL At last, the cases and their medians and limits are evaluated by clinical experts with Delphi. Result 59 cases and 116 types are determined, the median and upper and lower limits of days, total and drug expenditure are also determined. The expenditure control criteria can be determined according to the increase extent of medical expenditure. Conclusion Most of data isn't normal distribution. So it is better to determine the cases by type related diagnosis in hospital. The criteria of expenditure control are better determined by the median and inter -quartile range.