Study on the Existing State and Optimization Approach for Executing Orthopedic Case Simulation in a Pediatric Specialty Hospital Using CHS-DRG
Guo Xiaoyan
Gao Guangying
Xu Ning
Zhang Nianying
Zhang Na
You Chudi
Tian Jiashuai
Abstract：Objective:To guide cost control and the development of orthopedic specialty services in actual payment by thoroughly analyzing the functioning of DRG simulation in the pediatric orthopedic department of the Capital Institute of Pediatrics.Methods:A total of 736 patients from the orthopedic ward of the Capital Institute of Pediatrics were included as study subjects.The four-quadrant grouping method was employed to examine the profitability status of each diagnosis group in detail.A logistic regression model explored the key factors influencing profitability.Results:Congenital illnesses and traumas account for most pediatric orthopedic cases.Benefit groups(2 groups,4.8％),disadvantageous groups(15 groups,35.7％),key groups(8 groups,19.0％),and potential groups(17 groups,40.5％)are found using the Boston Matrix analysis.The profit group depends on the benefit groups(IF19,IH15)for 67.7％of its total revenue.No matter how profitable they are,medical consumables comprise a sizable portion(43％-45％).According to regression analysis,hospital profitability is highly impacted by age,consumable ratio,examination cost ratio,surgery cost ratio,and other cost ratios(P＜0.05).The consumable ratio is the most significant negative predictor(β=-2.238).Conclusion:Hospitals need to optimize their cost structure and increase the probability of profitability through refined management of consumables,the four-quadrant analysis method,strengthened cost accounting,and differentiated resource allocation.
Keywords：China Healthcare Security Diagnosis Related Groupspediatricorthopedicssimulated operationoptimization strategy
Publication Date：2024-11-05
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 21-26 )