关键词: 按项目付费, 疾病诊断相关分组付费, 均次住院费用

Abstract: Objective The problem of rapid increase in medical expenses in China is becoming increasingly severe. In order to solve this problem,China's medical insurance has begun to try to replace the previous pay-per-project payment method with diagnosis related groups（DRGs） payment.However,hospitals of traditional Chinese medicine have not implemented it yet. This study takes Shingles as an example to makes a preliminary exploration on what will happen if hospitals of traditional Chinese medicine participate in DRGs payment,and what changes should those hospitals make to cope with the change of this payment method. Methods A cross-sectional study and SPSS 24.0 statistical software were used to investigate which factors were associated with hospitalization costs of Shingles patients discharged from Tianjin academy of traditional Chinese medicine affiliated hospital in 2021,and the differences in hospital income between the two medicare payment methods. Results We found that the DRGs payment method has a great impact on traditional Chinese medicine hospitals. The payment by DRGs only accounts for 36.96% of the original payment by project,which is not enough to cover the cost of drugs and consumables. The influencing factors of hospitalization expenses are mainly related to the average length of stay and different departments. Conclusion There are many problems with the implementation of DRGs in traditional Chinese medicine hospitals,including poor medical cost control and insufficient understanding of DRGs. Therefore,it is necessary to pay more attention,improve the accuracy of enrollment,and implement the diagnosis and treatment plan and Clinical pathway.

Key words: Fee-for-service, Diagnosis related groups, DRGs, Average hospitalization costs