DRG支付模式下的信息化应用挑战与对策

中图分类号：R197.32 文献标志码：A 文章编码：1672-7274（2025）07-0125-03

Challenges and Countermeasures of Information Application underDRGPaymentMode

XU Gaofeng （QixiaMedical Insurance Center，Qixia City，Shandong Province，Qixia 2653oo，China）

Abstract： With the deepening of medical reform，the Diagnosis Related Groups （DRG） payment model， as an emerging mechanism for controlling medical expenses，is gradually being applied.Informationization is an important guarantee for the successul implementationof DRG mode，and itscore liesineffective data management and analysis.This article first outlines the definition，advantages，and pilot status of the DRG payment model. Then， thesystem implementationof thecore elementof DRG grouping Was elaborated indetail.Finall，thechallenges faced by information technologyapplications under the DRG payment model were analyzed，and corresponding countermeasures were proposed，aiming to provide reference for improving the informationization level of the DRG payment model， promoting the effective alocation of medical resources and the efficient utilization of medical insurance funds.

Keywords： DRG payment mode; information technologyapplication; challenge and countermeasures

1 DRG支付模式基本概述

1.1DRG支付模式的定义

DRG支付模式是一种基于医院患者住院病例特征的医保支付方式，其核心在于将相似类型的疾病和治疗过程进行分组，并为每一组设定固定的报销标准。（剩余4460字）