按病种分值付费对上海市某二甲综合性医院平均住院日的影响分析OA

Objective To study the changes in the average length of stay(ALOS)in a second-level general hospital un-der the Diagnosis-Intervention Packet(DIP)payment reform,and to provide decision-making insights for comprehensively evalu-ating medical services and quality management under the DIP payment reform from the perspective of its impact on ALOS.Meth-ods Hospitalization medical record front page data from July 1,2022,to June 30,2025(before and after DIP implementation)were extracted from the hospital's HQMS system.SPSS 23.0 was used to statistically analyze indicators such as ALOS,preopera-tive ALOS,postoperative ALOS,average hospitalization cost,surgical proportion,treatment outcomes,and accuracy rates of pri-mary diagnosis and primary surgery selection.T-tests or chi-square tests were employed to compare differences before and after the reform.Results After DIP implementation,the hospital's overall ALOS decreased by 0.6 days,and preoperative ALOS de-creased by 0.3 days,with statistically significant differences.Among the 31 clinical departments,16 showed a statistically signif-icant reduction in ALOS,while changes in other departments were not significant.Post-DIP reform,the Case Mix Index(CMI)increased by 0.080 9,and the number of DIP groups increased by 42.The accuracy rates of primary diagnosis and primary sur-gery documentation on the medical record front page both improved by 13％,with statistically significant differences confirmed by chi-square tests.Conclusion After implementing DIP payment,the hospital transformed its management approach,enhanced in-ternal management and medical service efficiency,improved disease treatment capacity,achieved a rapid reduction in ALOS(in-cluding preoperative and postoperative ALOS),elevated treatment levels and medical quality,and reduced medical costs.