Breakeven analysis of DRGs pilot in the hospital / 中华医院管理杂志

ABSTRACT

Objective To investigate the profit-loss of the hospital's DRGs pilot and its reasons.Methods An investigation of the profit-loss situation of 9 225 cases of a hospital in Beijing,who have been discharged from December 2011 to December 2013 and grouped into 105 DRG pilot groups.Results As shown in the medical records of 9 225 cases,96.54％ are covered by urban employee basic medical insurance,and 3.46％ by urban residents' medical insurance; 78 DRGs groups were recorded as with profit(74.29 ％),while 27 recorded as with a loss(25.71％) ;average length of stay as 9.37 days,average expense per hospitalization per person as 18 032.27 yuan,average quota standard as 17 337.53 yuan,average out-of-pocket cost as 829.47 yuan,average second charge as 2 448.57 yuan,average profit as 2 583.29 yuan,average sum of out-of-pocket payment ratio and second charge ratio as 12.46％.Conclusion The current DRGs pilot model shows the hospital as profit making in general,with no significant impact on the hospital.