Objective To evaluate the effect of day surgery with diagnosis-related groups (DRG) evaluation indicators. Methods The inpatients undergoing surgery in Beijing Tongren Hospital of Capital Medical University between March and September 2022 were enrolled in this study. The medical quality, medical efficiency, hospitalization cost, DRG insurance payment and other DRD-related indicators were retrospectively collected and compared between day surgery patients and non-day surgery patients, and the average length of hospital stay and hospitalization costs were compared between the two surgery modes within DRGs. Chi-square test was used for enumeration data, and t-test and Mann-Whitney U test were used for measurement data. Results A total of 29339 day surgery patients and 19019 non-day surgery patients were enrolled. In the day surgery group, the proportions of local patients (71.71% vs. 68.62%), routine discharge (99.93% vs. 99.78%), and class A incisions (99.92% vs. 99.55%) were better than those in the non-day surgery group (P<0.05), and the average length of hospital stay [(1.00±0.00) vs. (6.98±5.00) d] and the average hospitalization costs [(7306.62±4605.73) vs. (24913.97±24623.54) yuan] were lower than those in the non-day surgery group (P<0.05). The top 2 reduction of average length of hospital stay were in the CB49 group and CB39 group, decreasing by 87.45% and 86.24%, respectively. The top 2 reduction of hospitalization costs were in the DC19 group and CC15 group, decreasing by 84.15% and 73.61%, respectively. DRG payment balance of medical insurance in the day surgery group was higher than that in the non-day surgery group (22.95% vs. 5.98%). Conclusions Day surgery not only ensure the medical quality, but also shorten the length of hospital stay and reduce the burden of medical expenses. Day surgery can effectively improve the utilization efficiency of hospital bed resources, it is an effective measure to promote the high quality development of hospital and comply with DRG payment reform.
The refined management of medical equipment archives is the key to its effectiveness. This article shares the practical experience of refined management of medical equipment archives in a tertiary hospital in Chengdu. Medical equipment archives are divided into paper archives and electronic archives, and the process of archive management collection, organization, identification, statistics, storage, and utilization is introduced. The article also discusses the construction, application, and management of archive management systems, aiming to provide a reference for solving the problems faced by refined management of medical equipment archives, achieving comprehensive and effective management of medical equipment archives, and significantly improving the level of archive utilization.
Objective To investigate the effect of refined management on the reducing of the rate of delayed connection of thoracoscopic lung nodule surgery in day surgery. Methods Patients scheduled for thoracoscopic lung nodule surgery admitted to Daytime Medical Center of Deyang People’s Hospital from January to December 2022 and September 2023 to August 2024 were retrospectively selected. Patients admitted between January and December 2022 were divided into the pre-fine management group, while those admitted between September 2023 and August 2024 were divided into the post fine management group. The incidence of delayed connection of thoracoscopic lung nodule surgery in day surgery was compared between the two groups. Results A total of 888 patients were included. Among them, there were 419 cases in the pre-refined management group and 469 cases in the post refined management group. There was no statistically significant difference in the basic information between the two groups (P>0.05). In the pre-refined management group, 28 cases were delayed, the rate of delay was 6.68%. In the pre-refined management group, 7 cases were delayed, the rate of delay was 1.49%. There was a statistically significant difference in the occurrence of delayed reception between the two groups (χ2=15.744, P<0.001). Before refined management, the incidence of delayed reception caused by the patient’s own reasons and medical factors accounted for 28.57% (8/28) and 71.43% (20/28), respectively. Among them, the proportion of four factors was relatively high: preoperative examination imperfect and unqualified, anesthesia assessment not completed on time, surgical scheduling changed at will, and patients did not prepare for surgery according to the requirements. After refined management, the incidence of delayed reception caused by the patient’s own reasons and medical factors accounted for 71.43% (5/7) and 28.57% (2/7), respectively. Conclusion Refined management of daytime surgery is an effective measure to reduce the rate of delayed of thoracoscopic lung nodule surgery in daytime surgery.
Objective To evaluate the refined management effect of diagnosis related groups (DRG), summarize the experience of refined management, and put forward corrective measures for existing problems. Methods Patients who underwent day surgery services at Shantou Central Hospital between April 2021 and March 2023 were selected. According to the management mode, patients will be divided into a conventional management group (April 2021 to March 2022) and a refined management group (April 2022 to March 2023). The general condition, medical quality, and patient satisfaction indicators of two groups of patients were compared. And according to the DRG group stratification, the differences in medical indexes such as length of hospital stay, total hospitalization expenses, and postoperative complications between the two groups were analyzed. Results A total of 4 584 patients were included, including 1 686 in the conventional management group and 2 898 in the refined management group. There were statistically significant differences between the two groups in terms of patient source, surgical grade, and provincial weight coefficient (P<0.05). However, there was no statistically significant difference in gender, age, and discharge method (P>0.05). The satisfaction of the refined management group with surgical procedures, preoperative guidance, service attitude, and nursing skills was higher than that of the conventional management group (P<0.05). A total of 4 DRG groups (≥ 100 patients) were included, with 2 215 patients in the refined management group and 1 460 patients in the conventional management group. Among them, there were 1496 cases in the group CB39 (cataract surgery), 336 cases in the group GE10 (inguinal and abdominal hernia surgery, age<17 years old), 1412 cases in the group JB29 (partial mastectomy for non-malignant breast tumors), and 431 cases in the group NE19 (vulvar, vaginal, and cervical surgeries). Among them, in the group CB39 (cataract surgery), group GE10 (inguinal and abdominal hernia surgery, age<17 years old), group JB29 (partial mastectomy for non-malignant breast tumors), and group NE19 (vulvar, vaginal, and cervical surgeries), the total hospitalization cost and length of stay in the refined management group were lower than those in the conventional management group (P<0.05). In the group CB39 (cataract surgery) and group NE19 (vulvar, vaginal, and cervical surgeries), the incidence of postoperative complications in the refined management group was lower than that in the conventional management group (P<0.05). In the group GE10 (inguinal and abdominal hernia surgery, age<17 years), the incidence of pain and incision bleeding in the refined management group was lower than that in the conventional management group (P<0.05); In the group JB29 (partial mastectomy for non-malignant breast tumors), the incidence of incision infection in the refined management group was lower than that in the conventional management group (P<0.05). There was no statistically significant difference in other indicators between the two groups (P>0.05). Conclusion Carrying out refined management for day surgery can reduce medical expenses, shorten the length of hospital stay, improve medical quality, and promote the high-quality development of hospitals while ensuring medical safety.