Diagnosis-intervention packet-based Pareto chart of the proportion of high-cost cases and the analysis of the structure of hospitalization expenses

Abstract

BACKGROUND: In order to prevent the occurrence of high-cost cases, it is necessary to know the proportion of high-rate cases and the hospitalization cost of patients. OBJECTIVE: Through the analysis of the high-rate cases of various specialties in a first-class hospital in a province, the profit and loss situation of medical institutions under the diagnosis-intervention packets (DIP) payment reform was discussed to seek a more effective way of medical insurance payment reform. METHODS: Data of 1955 inpatients who participated in DIP settlement in January 2022 were retrospectively selected. The Pareto chart was used to analyze the distribution trend of high-cost cases and the composition of hospitalization expenses in each specialty. RESULTS: The high-cost cases are the main reason for the loss of medical institutions at the time of DIP settlement. Neurology, respiratory medicine and other specialties are the focus of high-cost cases. CONCLUSION: The cost composition of inpatients with high-cost cases is in urgent need of optimization and adjustment. DIP payment method can control the use of medical insurance funds more effectively, which is the guarantee for the refined management of medical institutions.

Optimizing Geriatric Venipuncture: A DRG-Compatible Team-Based Reengineering Strategy

“…The expenditure part of the 100-yuan index includes both chargeable and non-chargeable medical consumables. 20 In the case of indwelling needle procedures, only the indwelling needles and infusion joints can be charged separately, while items such as films, pads, disinfectant swabs, tourniquets, and hand disinfectants are considered non-chargeable.However, due to reimbursement policy restrictions, the usage and consumption of indwelling needles and additional infusion to greater economic loss for the hospital in this aspect. It is evident that the traditional intravenous indwelling needle care model is no longer suitable for the new payment system.…”

Impact of Medical–Pharmaceutical Separation Reform on Hospitalization Expenditure in Tertiary Public Hospitals: Difference-in-Difference Analysis Based on Panel Data from Beijing

“… 20 DIP effectively improves the level of fine management. 21 In China, from 1998 to 2010, the predominant health insurance payment method was per item payment. From 2011 to 2017, total budget payment, SDP and other payment methods were promoted in pilot healthcare institutions.…”