Objective To evaluate the coronavirus disease 2019 (COVID-19) impact on diagnosis related groups (DRGs) in a general hospital based on the front page of the medical record. Methods The first page data of discharge medical records of Nanjing First Hospital from February to March 2019 (before the epidemic) and from February to March 2020 (during the epidemic) were selected. Five indexes including total weight, number of DRGs, case mixed index index, time consumption index and cost consumption index were calculated. The rank of DRGs indexes of departments was compared by rank-sum ratio (RSR) method. The departments were sorted by frequency distribution and linear regression equation. Meanwhile, the COVID-19 impact on DRGs index of surgical departments and non operative departments was observed. Results Twenty-eight departments were included from February to March 2019, and 25 departments were included from February to March 2020. After the outbreak of COVID-19, the total DRGs index rank (RSR) decreased from 12.982 to 11.710. Ophthalmology, burn and plastic surgery, orthopedics, otorhinolaryngology, stomatology and pain department were the departments with lower ranking; the departments of gynecology, oncology, immunology and neurology were ranked higher. After the outbreak of COVID-19, the DRGs related indexes of surgical departments and non-surgical departments decreased significantly in terms of total weight and the number of DRGs (P<0.05). Conclusions COVID-19 affects the overall quality of hospital difficulty, and the surgical departments are significantly involved. The RSR level of several departments is reduced. In the face of the epidemic situation, hospitals should offset or weaken the uncertainty brought by the epidemic situation to the hospital disease treatment and ensure the high-quality hospital treatment by improving the “technical source”, ensuring the “disease source pool”, optimizing the “process chain” and strengthening the “new media”.
This article is based on the work practice of Medical-lnsurance-Medicine Linkage carried out by the Nanping First Hospital Affiliated to Fujian Medical University under the reform of payment based on diagnosis related group (DRG). It outlines the connotation and extension of Medical-lnsurance-Medicine Linkage in the hospital, including concept definition, organizational structure, the relationship between DRG payment and Medical-lnsurance-Medicine Linkage, and summarizes the specific measures and positive results of the Medical-lnsurance-Medicine Linkage work mechanism from four aspects: medical quality management, medical insurance management, medical drugs/consumables management, and performance evaluation. These experiences are of great significance for improving the quality and efficiency of medical care, actively responding to the reform of medical insurance payment methods, enhancing the level of medical services in public hospitals, and achieving a win situation among the medical insurance management departments, hospitals, and patients.