Objective:To evaluate the reduced hospitalization time and medical expenses of diagnosis-related groups(DRG) in day surgery, and to provide scientific basis for the accurate selection of day surgery.Methods:Data of medical records from July to November 2018 were extracted from day surgery and ordinary hospitalization. Time consumption and cost consumption indexes between day surgery and ordinary hospitalization of each DRG group were compared. Then the most significant and least significant DRG group and operation type were selected based on the comprehensive index ranking.Results:1 997 patients were included in day operation, the time consumption index was 0.31, and the cost consumption index was 0.55; 10 506 ordinary hospitalization patients were selected, the time consumption index was 1.31, and the cost consumption index was 1.09. The time and cost consumption indexes of surgeries such as skin lesion resection, facial lesion resection, deep cervical lymph node resection were shortened most significantly in day surgery, while the time and cost consumption indexes of minimally invasive mastectomy were decreased least significantly.Conclusions:According to the reducion of time and cost consumption index, DRG group and operation with the most significant reduction can be regarded as the priority of day surgeries under the same security level, while the DRG group with the least significant reduction is not recommended as the priority of day surgery.

Objective:To analyze the effect of diagnosis-related groups prospective payment system(DRG-PPS) on medical service quality.Methods:Literature on DRG-PPS impact on medical service quality was searched in Chinese and English databases, and inclusion and exclusion criteria were formulated. Meta analysis was performed on the average length of stay, mortality and readmission rate, and the results of other indicators were described and integrated.Results:A total of 33 articles were included for analysis. Meta analysis showed that the implementation of DRG-PPS could shorten the average length of stay, WMD=-0.67(95% CI: -0.91 to-0.43); the implementation of DRG-PPS had no significant impact on the readmission rate( OR=0.97, 95% CI: 0.87-1.08); the implementation of DRG-PPS did not have a significant impact on the death rate of patients( OR=0.98, 95% CI: 0.93-1.03). The results of narrative integration showed that DRG-PPS had no significant effect on the incidence of complications, patient satisfaction, quality of life, service and operation process indicators. Conclusions:DRG-PPS can shorten the average length of stay, but has no significant effect on mortality and readmission rate.

目的 应用自回归求和移动平均(Autoregressive Integrated Moving Average Model,ARIMA)乘积季节模型分析和预测恶性肿瘤住院量、住院费用及平均住院时间,为医院恶性肿瘤业务管理提供科学依据.方法 收集某院2007-2016年逐月十大恶性肿瘤(肺癌、肝癌、白血病、结直肠癌、胃癌、甲状腺癌、恶性淋巴瘤、前列腺癌、乳腺癌和肾癌)住院患者资料,采用ARIMA乘积季节模型对2007-2015年逐月恶性肿瘤的住院人次、住院费用和平均住院时间进行模型拟合,用2016年逐月数据评价其预测效果,并预测2017和2018年该十大恶性肿瘤逐月住院人次、住院费用及平均住院时间.结果 ARIMA(0,1,1)(0,1,1)12是恶性肿瘤住院人次、住院费用及平均住院时间的最佳拟合预测模型,拟合相对误差分别为-0.89％、4.71％及-0.80％.根据ARIMA(0,1,1)(0,1,1)12预测结果,2017年该十大恶性肿瘤住院量将达21 489人次,住院费用将达11.06亿元,平均住院时间将迭11.29 d.2018年住院量将增至22 894人次,住院费用将高达14.01亿元,平均住院时间将缩短至10.45 d.结论 ARIMA季节乘积模型能较好地应用于医院业务管理预测中.