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南京医科大学学报（社会科学版）京医科大学学报（社会科学版）
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Journal of Nanjing Medical University（Social Sciences）of Nanjing Medical University（Social Sciences） 2026年6月
Journal
倍率病例管理实践［J］. 卫生经济研究，2023，40（8）： 倍率病例差异及住院费用灰色关联分析［J］. 中国医
37-39 院，2023，27（5）：55-58
［17］张雅莉，荆媛，姚魏紫，等. 基于 DRG 的剖宫产病例分 ［20］任雨青，李伟，丁锦希. 资源配置视角下DRG病组费用
组效果与费用结构分析［J］. 卫生经济研究，2020，37 结构变动分析［J］. 中国卫生经济，2025，44（11）：50-
（7）：37-40 53，62
［18］ 徐静晗，邓应梅，李天舒. 基于灰色关联与结构变动度 ［21］牛亚冬，张亮，张翔，等. 医保系统和医疗系统协同发
分析医疗改革对某公立医院医疗费用的影响［J］. 中国 展探讨：目标、分工与协作［J］. 中国卫生政策研究，

病案，2020，21（12）：73-77 2023，16（10）：35-40
［19］王文君，贾晓倩，周道平，等. DRG 高倍率病例与正常 （本文编辑：姜 鑫）

Analysis of the hospitalization costs structure for special cases in public

hospitals under the DRG payment system

1
2
1
GU Wennuo ，REN Pingping ，ZHAO Yunwu ，WANG Heng 1，3
1. School of Health Management，Anhui Medical University，Hefei 231200；2. Department of Post⁃Graduate Education，
3. Dean’s Office，the First Affiliated Hospital of Anhui Medical University，Hefei 230032，China
Abstract：This study conducted a descriptive analysis of the number of cases，average length of stay，
average per⁃case cost，average daily cost，and cost composition based on the front⁃page medical record of
4，653 special cases from a provincial tertiary hospital in Hefei in 2024. Univariate analysis revealed that age，
gender，length of stay，medical insurance type，presence of complications，DRG category and department
category all significantly influenced hospitalization costs for special cases. Structural equation modeling analysis
indicated that special cases constituted 12.64% of total cases，yet accounted for 22.71% and 29.81% of total
length of stay and hospitalization costs，respectively，indicating significant resource consumption. Costs for high⁃
cost cases were primarily composed of material fees，while low⁃cost cases were dominated by laboratory test fees.
Both cost structures exhibited a pattern of heavy reliance on material consumption and low labor costs. The
study suggests that hospitals should adjust the medical cost structure，shorten the average length of stay and
refine medical insurance payment policies through the DRG payment tool. These measures help achieve the
goals of cost control，quality improvement and efficiency enhancement，thereby promoting a win⁃win situation
for healthcare providers，medical insurers and patients.
Key words：DRG；special cases；high⁃cost cases；low⁃cost cases