RESUMO
OBJECTIVE: To examine the applicability of an Australian casemix classification system to the description of Chinese hospital activity. DESIGN: A total of 161,478 inpatient episodes from three Chengdu hospitals with demographic, diagnosis, procedure and billing data for the year 1998/1999, 1999/2000 and 2000/2001 were grouped using the Australian refined-diagnosis related groups (AR-DRGs) (version 4.0) grouper. MAIN OUTCOME MEASURES: Reduction in variance (R2) and coefficient of variation (CV). RESULTS: Untrimmed reduction in variance (R2) was 0.12 and 0.17 for length of stay (LOS) and cost respectively. After trimming, R2 values were 0.45 and 0.59 for length of stay and cost respectively. CONCLUSIONS: The Australian refined DRGs provide a good basis for developing a Chinese grouper.
Assuntos
Grupos Diagnósticos Relacionados/estatística & dados numéricos , Hospitais Públicos/estatística & dados numéricos , Hospitais Urbanos/estatística & dados numéricos , Revisão da Utilização de Recursos de Saúde/métodos , China , Alocação de Custos/métodos , Grupos Diagnósticos Relacionados/classificação , Cuidado Periódico , Custos Hospitalares/estatística & dados numéricos , Hospitais Públicos/economia , Hospitais Urbanos/economia , Humanos , Classificação Internacional de Doenças , Tempo de Internação , Discrepância de GDHRESUMO
Health sector reform in China has led to increasing responsibility for hospital managers in the management of staff; but constraints continue. New personnel reforms offer new opportunities but face a number of difficulties. Drawing on research in Chinese hospitals in 1997 this paper identifies two major obstacles to improved human resource management: wage policy and lack of control by local managers over staffing.
