{"title":"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。","authors":"Lanhua Liu, Ying Wang, Xiaoyun Cheng, Xiaoyue Yuan, Xuanyu Tian, Tao Zhang","doi":"10.1111/jep.70290","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>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.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>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.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>QCC implementation showed high intensity scores (<i>M</i> = 4.16, SD = 0.93) with strong correlations to standardized operational procedures (<i>ρ</i> = 0.798). Nursing quality improvements were substantial (<i>M</i> = 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.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>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.</p>\n \n <p><b>Clinical trial number:</b> Not applicable.</p>\n </section>\n </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 7","pages":""},"PeriodicalIF":2.1000,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Effectiveness of Quality Control Circle-Based Nursing Quality Improvement in Reducing DRG Costs in General Surgery: A Cross-Sectional Survey Study\",\"authors\":\"Lanhua Liu, Ying Wang, Xiaoyun Cheng, Xiaoyue Yuan, Xuanyu Tian, Tao Zhang\",\"doi\":\"10.1111/jep.70290\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>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.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>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.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>QCC implementation showed high intensity scores (<i>M</i> = 4.16, SD = 0.93) with strong correlations to standardized operational procedures (<i>ρ</i> = 0.798). Nursing quality improvements were substantial (<i>M</i> = 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.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusion</h3>\\n \\n <p>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.</p>\\n \\n <p><b>Clinical trial number:</b> Not applicable.</p>\\n </section>\\n </div>\",\"PeriodicalId\":15997,\"journal\":{\"name\":\"Journal of evaluation in clinical practice\",\"volume\":\"31 7\",\"pages\":\"\"},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2025-09-30\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of evaluation in clinical practice\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/jep.70290\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"HEALTH CARE SCIENCES & SERVICES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of evaluation in clinical practice","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/jep.70290","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
Effectiveness of Quality Control Circle-Based Nursing Quality Improvement in Reducing DRG Costs in General Surgery: A Cross-Sectional Survey Study
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.
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.
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