CAJ | 학술논문

本研究利用上海市37家三级公立医院2013年12月的所有138477条出院病例数据，根据本土化的病种分组器对其进行疾病分组，选用各组的变异系数（ CV）指标对各组次均费用的离散度进行分析，以评价病种分组系统的适宜性，并设置各病种难度系数（相对权重）。研究发现基于危重度的疾病诊断分组系统适宜性较好，一致性也很高。在今后的研究中应收集更为详细的费用信息以体现医疗服务中的劳务和技术价值，并且进一步完善疾病分组，因地制宜地应用分组权重。
본연구이용상해시37가삼급공립의원2013년12월적소유138477조출원병례수거，근거본토화적병충분조기대기진행질병분조，선용각조적변이계수（ CV）지표대각조차균비용적리산도진행분석，이평개병충분조계통적괄의성，병설치각병충난도계수（상대권중）。연구발현기우위중도적질병진단분조계통괄의성교호，일치성야흔고。재금후적연구중응수집경위상세적비용신식이체현의료복무중적노무화기술개치，병차진일보완선질병분조，인지제의지응용분조권중。
This paper uses the data collected from 138,477 patient discharge records of 37 Shanghai tertiary public hospitals in December 2013 and classifies all the records into different groups by using a localized diagnosis re-lated group tool.The coefficient of variation index ( CV) of each group was used to analyze the dispersion of average hospital cost per inpatient day for each group, in order to evaluate the suitability of diagnosis related group systems and to set the coefficients of difficulty ( relative weights) for each disease.The study has found that severity-based di-agnosis related group systems are more suitable and consistent.However, future studies should collect more detailed information on health costs in order to reflect the value of health professionals and technologies and therefore further improve diagnosis related classification and develop new systems that can be adapted to local conditions by applying the weights of different groups.