Effectiveness of Quality Control Circle-Based Nursing Quality Improvement in Reducing DRG Costs in General Surgery: A Cross-Sectional Survey Study

IF 2.1 4区医学 Q3 HEALTH CARE SCIENCES & SERVICES

Journal of evaluation in clinical practice Pub Date : 2025-09-30 DOI:10.1111/jep.70290

Lanhua Liu, Ying Wang, Xiaoyun Cheng, Xiaoyue Yuan, Xuanyu Tian, Tao Zhang

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引用次数: 0

Abstract

Background

The implementation of Diagnosis-Related Group (DRG) payment systems globally has intensified pressure on healthcare institutions to control costs while maintaining quality. Quality Control Circles (QCCs) have emerged as a promising continuous quality improvement method in nursing management. This study investigated the effectiveness of QCC-based nursing quality improvement on DRG cost control in general surgery departments.

Methods

A cross-sectional survey was conducted among 50 healthcare professionals (18 physicians, 21 nurses, 8 nursing quality control staff, and 3 others) in a general surgery department. The survey assessed QCC implementation intensity, DRG knowledge, nursing improvement effects, and cost control obstacles. Descriptive statistics, Spearman correlation analysis, and Mann-Whitney U tests were performed to analyze relationships between variables.

Results

QCC implementation showed high intensity scores (M = 4.16, SD = 0.93) with strong correlations to standardized operational procedures (ρ = 0.798). Nursing quality improvements were substantial (M = 4.38, SD = 0.73), and higher scores in key dimensions such as standardized preoperative education and multimodal analgesia were associated with fewer postoperative complications and shorter length of stay, thereby directly supporting DRG cost control.

Conclusion

QCC-based nursing quality improvement demonstrates effectiveness in supporting DRG cost control in general surgery through standardized processes and enhanced nursing practices. Among these achievements, the rationalization management score of high‑value consumables was the highest (M  =  4.40), directly reducing the proportion of consumables cost within the DRG group, which makes the cost‑control effect more specific and clinically meaningful. The findings suggest that systematic implementation of QCC methodologies can facilitate both quality improvement and cost containment objectives within DRG payment frameworks.

Clinical trial number: Not applicable.

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基于质量控制圈的护理质量改进对降低普外科DRG成本的有效性：一项横断面调查研究。

背景：全球范围内诊断相关组（DRG）支付系统的实施加大了医疗机构在保持质量的同时控制成本的压力。质量控制圈（qcc）已成为护理管理中一种有前途的持续质量改进方法。本研究旨在探讨基于质量保证的护理质量改进对普外科DRG成本控制的效果。方法：对某普外科50名医护人员（内科医生18名，护士21名，护理质控人员8名，其他3名）进行横断面调查。调查评估了质量中心实施强度、DRG知识、护理改善效果和成本控制障碍。采用描述性统计、Spearman相关分析和Mann-Whitney U检验分析变量之间的关系。结果：QCC的实施表现出高强度评分（M = 4.16, SD = 0.93），与标准化操作程序有很强的相关性（ρ = 0.798）。护理质量显著提高（M = 4.38, SD = 0.73），标准化术前教育、多模式镇痛等关键维度得分越高，术后并发症越少，住院时间越短，直接支持DRG成本控制。结论：通过规范流程和加强护理实践，以质量保证为基础的护理质量改进能够有效支持普外科DRG成本控制。其中，高值耗材合理化管理得分最高（M = 4.40），直接降低了耗材成本在DRG组内的占比，使成本控制效果更具针对性和临床意义。研究结果表明，系统地实施质量保证中心方法可以促进DRG支付框架内的质量改进和成本控制目标。临床试验号：不适用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of evaluation in clinical practice 医学-卫生保健

CiteScore

4.80

自引率

4.20%

发文量

143

审稿时长

3-8 weeks

期刊介绍： The Journal of Evaluation in Clinical Practice aims to promote the evaluation and development of clinical practice across medicine, nursing and the allied health professions. All aspects of health services research and public health policy analysis and debate are of interest to the Journal whether studied from a population-based or individual patient-centred perspective. Of particular interest to the Journal are submissions on all aspects of clinical effectiveness and efficiency including evidence-based medicine, clinical practice guidelines, clinical decision making, clinical services organisation, implementation and delivery, health economic evaluation, health process and outcome measurement and new or improved methods (conceptual and statistical) for systematic inquiry into clinical practice. Papers may take a classical quantitative or qualitative approach to investigation (or may utilise both techniques) or may take the form of learned essays, structured/systematic reviews and critiques.