Grouping effects and cost influencing factors of DRG in orthopedic spine surgery cases

Abstract

Objective: Analyzing the grouping effect of DRG in orthopedic spine surgery and influencing factors of hospitalization expenses, so as to provide the basis for DRG payment reform and control of medical expenses.Methods:The information of 248 cases of spinal surgery in sample hospitals was analyzed statistically, the grouping effect of DRG was evaluated by the coefficient of variation, and the influencing factors of hospitalization expenses were analyzed by single factor analysis and multiple stepwise regression analysis.Results:Patients who underwent orthopedic spine surgery were divided into three DRG groups: IB19, IB21 and IB23, with CV values of 0.37, 0.47 and 0.44, respectively, all of which were less than 0.5. Univariate analysis showed that age, comorbidities, hospital stay, critical illness and anesthesia mode affected hospital expenses, and the differences were statistically significant (P < 0.05). Payment method and gender did not affect the hospitalization expenses, and the difference was not statistically significant (P>0.05). Stepwise regression analysis showed that comorbidities, hospitalization time, dying or seriously ill, anesthesia method and age were the main influencing factors of hospitalization expenses.Conclusion: The grouping of DRG in spine surgery cases can objectively reflect the level of medical resource consumption. Hospitals should use DRG payment reform as a breakthrough to promote clinical pathway management, standardize diagnosis and treatment procedures, shorten hospital stay, and control the unreasonable growth of medical expenses.