借助信息化系統(tǒng)賦能DRG全流程管理

中圖分類號：R197.324；TP31 文獻(xiàn)標(biāo)志碼：A 文章編碼：1672-7274（2025）05-0200-03

Abstract： This article focuses on the research of empowering DRG full process management with the help of information systems.Firstly，the project background was introduced， including the process and requirements of promoting DRG payment reform through relevant national policies.Then， some pain points currently existing in hospitals were elaborated，such as difficulties in information data fusion，pre grouping of DRG cases，filling in medicalinsurance list diagnosis and surgical operations，and in-hospital operation management issues.Then the main purpose was explained，which is toachieve refined managementof hospital medical insurance operations.It also introduces management toolsandobjectives，including establishing relevant systems toachievereal-time monitoring and data analysis to achieve refined management goals.Finaly，summarize the project，covering itsachievements， shortcomings， and future prospects.

Keywords： information system; DRG; fullprocess management; hospitaloperation; reformofmedicalinsurance payment

1 項(xiàng)目背景

2019年6月5日，國家醫(yī)保局、財(cái)政部、國家衛(wèi)生健康委、國家中醫(yī)藥局等四部委聯(lián)合發(fā)布《關(guān)于印發(fā)按疾病診斷相關(guān)分組付費(fèi)國家試點(diǎn)城市名單的通知》（以下簡稱“通知”），公布了30個(gè)DRG付費(fèi)國家試點(diǎn)城市名單。（剩余4279字）