互斥、非互斥？診斷組合(DRGs)分類結構之辨

An Exptanatory Analysis of DRGs' Mutual Exclusive Theory

韓揆(Kuei Han)

《台灣公共衛生雜誌》 20卷4期 (2001/08) Pp. 259-264

https://doi.org/10.6288/TJPH2001-20-04-02

摘要

DRGs（診斷組合），作為一個醫院管理及醫療費用支付制度，其分類之周延性及互斥性甚為重要，由於DRGs是綜合疾病分類、臨床分類、病人分類及醫院作業分類而產生的一個新結構，一般醫療及醫院管理學者不易了解其分類邏輯及功能，甚至誤認其分類之互斥性。導致盲從迴響。本文藉一位臨床醫師的質疑詳細剖析DRGs的設計精神及為何一般人容易對它產生誤識，期望對學界，有關業者及學生產生新認知及提升認真作學問的精神。

關鍵字

診斷組合（DRGs） ； 論病例計酬 ； 醫院管理

並列摘要

Exhaustive and Exclusive are the base that constructs the classification system of DRGs. Some surgeon physician, however, published and argued that at the standpoint of a clinician's view, it, including the ICD-9-CM system, is not structurally exclusive. The article is referred by some chief medical record technician at a large hospital as well as hospital administration students in Taiwan. The author analyzed the article's argument and made clear how the DRGs grouping behavior was formulated. It is hoped that readers of this paper can gain a broader insight of DRGs theory and avoid misleading or being misled.

並列關鍵字

DRGs ； case mix ； hospital administration.