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目的:研究应用较广的8个诊断相关组(Diagnosis-related Groups,DRGs)体系(APR-DRGs、AR-DRGs、MS-DRGs、APS-DRGs、TW-DRGs、G-DRGs、GHM、HRG),以探讨在建立适合我国国情的、预测效率更高的、保健与临床意义更清晰的妇婴专科DRGs体系过程中可汲取的国际经验以及建模中需注意的问题。方法:采用文献研究和专家评议的方法。研究资料主要来源于Cochrane Database of Systematic Reviews、MEDLINE、Web of Science、Internet和中国知网全文数据库。结果:各国的妇婴专科DRGs分组差异加大,主要差异为分组逻辑和并发症与合并症再分组方法。在研究的DRGs系统中,女性生殖系统疾病或紊乱组(MDC13):AR-DRGs的DRGs分组最少,共计22个DRGs,GHM的分组最多,共计94个GHMs。妊娠、分娩和产褥期(MDC14)组:DRGs分组最少为MS-DRGs,共计15个DRGs,最多为APR-DRGs,共计48个DRGs。新生儿(MDC15)组:ADRGs和DRGs最少的都为MS-DRGs,共计6个ADRGs和7个DRGs,最多的都是APR-DRGs,共计28个ADRGs和112个DRGs。结论:中国的妇婴专科DRGs研究与应用应借鉴国际经验,应重点关注妇婴专科特色、分组数据标准和质量、全面的DRGs研究与管理团队。
OBJECTIVE: To study the diagnostic and related groups (APR-DRGs, AR-DRGs, MS-DRGs, APS-DRGs, TW-DRGs, G-DRGs, GHM and HRG) In order to explore the international experience that can be drawn up in the process of establishing a maternal and child specialist DRGs system with a higher predictive efficiency and health and clinical significance that suits our national conditions and the problems to be noted in modeling. Methods: Using literature research and expert evaluation method. The research data mainly come from Cochrane Database of Systematic Reviews, MEDLINE, Web of Science, Internet and CNKI full-text database. Results: The discrepancies in maternal and child specialist DRGs in different countries were significantly different. The main differences were the logic of grouping and the complication and complications of subgroups. In the studied DRGs system, the female reproductive system disorders or disorders group (MDC13): AR-DRGs had the fewest DRGs with a total of 22 DRGs, with the largest grouping of GHMs for a total of 94 GHMs. Pregnancy, childbirth and the puerperium (MDC14) group: At least 16 DRGs, up to APR-DRGs, for a total of 48 DRGs, were included in the DRGs group with a minimum of MS-DRGs. Newborn (MDC15) group: ADRGs and DRGs are the least for both MS-DRGs, with a total of 6 ADRGs and 7 DRGs, most of which are APR-DRGs, for a total of 28 ADRGs and 112 DRGs. Conclusion: The research and application of DRGs in maternity and infants in China should learn from international experience and should focus on maternity and infant specialties, grouping data standards and quality, and comprehensive DRGs research and management team.