DRGﺿﺮﻭﺭﺕ ﺍﻳﺠﺎﺩ ﺳﻴﺴﺘﻢ ﻣﻠﻲ - ﺑﻴﻤﺎﺭﻱ ﻫﺎﻱ ﻗﻠﺐ ﻭ ﻋﺮﻭﻕ ﺩﺭ ﺍﻳﺮﺍﻥ

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(37) 12 ؛1388 ﺖﻣﻼﺳ ﺖﻳﺮﻳﺪﻣ

ﻥﺍﺮﻳﺍ ﺭﺩ ﻕﻭﺮﻋ ﻭ ﺐﻠﻗ ﻱﺎﻫ ﻱﺭﺎﻤﻴﺑ

3ﻲﻧﺎﺑﺮﻗ ﻪﻟﺍ ﻲﻟﻭ / ²ﻱﺭﺪﻔﺻ ﺎﺿﺭ / ¹ﻲﻤﺠﻨﻣ ﺪﻴﺷﺮﻓ

ﻩﺪﻴﻜﭼ ﻪﺑ ﺯﺎﻴﻧ -ﻕﻭﺮﻋ ﻭ ﺐﻠﻗ ﻲﺼﺼﺨﺗ ﺰﻛﺍﺮﻣ ﺭﺩ ﻪﻠﻤﺟﺯﺍ– ﻩﺪﺷ ﻪﺋﺍﺭﺍ ﺕﺎﻣﺪﺧ ﺖﺧﺍﺩﺮﭘﺯﺎﺑ ﻭ ﺖﺧﺍﺩﺮﭘ ﻡﺎﻈﻧ ﺭﺩ ﻖﻴﻗﺩ ﻱﺰﻳﺭ ﻪﻣﺎﻧﺮﺑ ﻱﺍﺮﺑ :ﻪﻣﺪﻘﻣ ﻦﻳﺍ ﻑﺪﻫ .ﺖﺳﺍ ﻩﺪﺷ ﺩﺎﺠﻳﺍﺯﺎﻴﻧ ﻦﻳﺍ ﻪﺑ ﻲﻳﻮﮕﺑﺍﻮﺟ ﻱﺍﺮﺑ (^DRG) ﻂﺒﺗﺮﻣ ﻲﺼﻴﺨﺸﺗ ﻱﺎﻫ ﻩﻭﺮﮔ ﻢﺘــﺴﻴﺳ .ﺪﺷﺎﺑ ﻲﻣ ﻪﻨﻳﺰﻫ ﺩﺭﻭﺁﺮﺑ ﻢﺘــﺴﻴﺳ .ﺩﻮﺑ ﻥﺍﺮﻳﺍ ﺎﺑ ﺐﺨﺘﻨﻣ ﻱﺎﻫﺭﻮﺸﻛ ﺭﺩ ﻕﻭﺮﻋ ﻭ ﺐﻠﻗ ﻱﺎﻫ ﻱﺭﺎﻤﻴﺑ ^DRG ﻢﺘﺴﻴﺳ ﻪﺴﻳﺎﻘﻣ ﻭ ﻪﻌﻟﺎﻄﻣ ﺶﻫﻭﮋﭘ ﺕﺎﻳﺮﺸﻧ ،ﺎﻫ ﺏﺎﺘﻛ ﺭﺩ ﺩﻮﺟﻮﻣ ﺕﺎﻋﻼﻃﺍ .ﺖﺳﺍ ﻩﺪﺷ ﻡﺎﺠﻧﺍ 1386-87 ﻝﺎﺳ ﺭﺩ ﻲﻘﻴﺒﻄﺗ -ﻲﻔﻴﺻﻮﺗ ﺵﻭﺭ ﻪﺑ ﺮﺿﺎﺣ ﺶﻫﻭﮋﭘ :ﻲﺳﺭﺮﺑ ﺵﻭﺭ ﺎﻫ ﻢﺘﺴﻴﺳ ﻞﻴﻠﺤﺗﻭ؛ ﺝﺍﺮﺨﺘﺳﺍ ﺎﻬﻧﺁ ^DRG ﻢﺘﺴﻴﺳ ﺭﺎﺘﺧﺎﺳ (ﺍﺩﺎﻧﺎﻛ ﻭ ﺎﻴﻟﺍﺮﺘــﺳﺍ ،ﺲﻴﻠﮕﻧﺍ ،ﺎﻜﻳﺮﻣﺍ) ﺐﺨﺘﻨﻣ ﻱﺎﻫﺭﻮــﺸﻛ ﺎﺑ ﻪﺒﺗﺎﻜﻣ ﻭ ،ﺖﻧﺮﺘﻨﻳﺍ ﻭ .ﺪﺷ ﻪﺴﻳﺎﻘﻣ ﻝﻭﺍﺪﺟ ﺎﺑ ﻱﺎﻫ ﻱﺭﺎﻤﻴﺑ ﻱﺪﻨﺑ ﻪﻘﺒﻃ ﻱﺍﺮﺑ ﺍﺭ ﺎﻫﺭﻮﺸﻛ ﻥﺁ ﻲﺘﺷﺍﺪﻬﺑ ﻱﺎﻫﺯﺎﻴﻧ ﺎﺗ ﻩﺪﻣﺁ ﺭﺩ ﻲﻠﻣ ﺕﺭﻮﺻ ﻪﺑ ^DRG ﻢﺘﺴﻴﺳ ،ﺐﺨﺘﻨﻣ ﻱﺎﻫﺭﻮﺸﻛﺭﺩ :ﺎﻫ ﻪﺘﻓﺎﻳ ﺖﻳﺎﻋﺭ .ﺩﻮﺷ ﻲﻣ ﻩﺪﻳﺩ ^DRG ﻢﺘــﺴﻴﺳ ﻦﻴﻧﺍﻮﻗ ﺮﺑ ﺮﻇﺎﻧ ﻭ ﻱﺮﺠﻣ ﻱﺎﻫ ﻥﺎﻣﺯﺎــﺳ ﺐﺨﺘﻨﻣ ﻱﺎﻫﺭﻮــﺸﻛ ﻡﺎﻤﺗ ﺭﺩ .ﺪﻳﺎﻤﻧ ﻩﺩﺭﻭﺁﺮﺑ ﻕﻭﺮﻋ ﻭ ﺐﻠﻗ ،ﺎﻫ ﻩﺩﺍﺩ ﻝﺩﺎﺒﺗ ﻪﺑ ﻁﻮﺑﺮﻣ ﻦﻴﻧﺍﻮﻗ ﻦﻴﻨﭽﻤﻫ ،ﺩﺭﺍﺪﻧﺎﺘﺳﺍ ﻱﺎﻫ ﻥﺎﻣﺯﺎﺳ ﻑﺮﻃ ﺯﺍ ﻩﺪــﺷ ﻦﻴﻴﻌﺗ ﻱﺎﻫﺩﺭﺍﺪﻧﺎﺘــﺳﺍ ﻭ ﻥﺩﺮﻛ ﻲﻣﻮﺑ ﻪﺑ ﻁﻮﺑﺮﻣ ﻦﻴﻧﺍﻮﻗ ﻱﺎﻫ ﻱﺭﺎﻤﻴﺑ ^DRG ﻲﻠﻣ ﻢﺘﺴﻴﺳ ﺪﻗﺎﻓ ﻥﺍﺮﻳﺍ .ﺩﻮــﺷ ﻲﻣ ﻩﺪﻳﺩ ﺐﺨﺘﻨﻣ ﻱﺎﻫﺭﻮﺸﻛ ^DRG ﻢﺘﺴﻴﺳ ﺭﺩ ﻱﺯﺎــﺳﺪﻣﺁﺯﻭﺭ ﺪﻧﻭﺭ ﻭ ﻱﺮﻳﺬﭘ ﻪﻌــﺳﻮﺗ .ﺖﺳﺍ ﻕﻭﺮﻋ ﻭ ﺐﻠﻗ ﻭﺮﺸﻴﭘ ﻱﺎﻫﺭﻮﺸﻛ ﺕﺎﻴﺑﺮﺠﺗ ﺯﺍ ﻩﺩﺎﻔﺘﺳﺍ ،ﺮﻣﺍ ﻲﻟﻮﺘﻣ ﻥﺍﻮﻨﻋ ﻕﻭﺮﻋ ﻭ ﺐﻠﻗ ﻱﺎﻫ ﻱﺭﺎﻤﻴﺑ ^DRG ﻢﺘﺴﻴﺳ ﻲﺼﺼﺨﺗ ﻪﺘﻴﻤﻛ ﺩﺎﺠﻳﺍ :ﻱﺮﻴﮔ ﻪﺠﻴﺘﻧ ﻢﺘﺴﻴﺳ ﻥﺪﺷ ﺯﻭﺭ ﻪﺑ ﻥﺎﻜﻣﺍ ،ﻥﺍﺮﻳﺍ ﺭﺩ ﺖﻣﻼﺳ ﻡﺎﻈﻧ ﻱﺎﻘﺗﺭﺍ ﺖﻬﺟ ﺭﺩ ﻱﺭﺍﺬﮔﺪﻛ ﻲﻠﻣ ﻱﺎﻫﺩﺭﺍﺪﻧﺎﺘﺳﺍ ﻱ ﻪﻌﺳﻮﺗ ،ﻢﺘﺴﻴﺳ ﻥﺩﺮﻛ ﻲﻠﻣ ﻪﻨﻴﻣﺯ ﺭﺩ .ﺩﻮﺷ ﻲﻣ ﺩﺎﻬﻨﺸﻴﭘ ﻥﺍﺭﺍﺬﮔﺪﻛ ﻪﺑ ﻡﺯﻻ ﺵﺯﻮﻣﺁ ،ﺭﻮﺸﻛ ﻞﺧﺍﺩ ﺭﺩ ﻩﺪﺷ ﻲﺣﺍﺮﻃ .ﺐﺨﺘﻨﻣ ﻱﺎﻫﺭﻮﺸﻛ ،ﻱﺭﺍﺬﮔﺪﻛ ،ﻕﻭﺮﻋ ﻭ ﺐﻠﻗ ﻱﺎﻫ ﻱﺭﺎﻤﻴﺑ ،ﻕﻭﺮﻋ ﻭ ﺐﻠﻗ ﻱﺎﻫ ﻱﺭﺎﻤﻴﺑ ^DRG ﻢﺘﺴﻴﺳ :ﺎﻫ ﻩژﺍﻭ ﺪﻴﻠﻛ 88/7/15 :ﻲﻳﺎﻬﻧ ﺵﺮﻳﺬﭘ • 88/6/28 :ﻲﻳﺎﻬﻧ ﺡﻼﺻﺍ • 88/5/23 :ﻪﻟﺎﻘﻣ ﻝﻮﺻﻭ •

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(37) 12 ؛1388 ﺖﻣﻼﺳ ﺖﻳﺮﻳﺪﻣ

ﻪﻣﺪﻘﻣ ﻪﻠﻴــﺳﻭ ،ﺖﺑﺎﻗﺭ ﺭﺍﺰﺑﺍ ،ﺕﺭﺪﻗ ﻊﺒﻨﻣ ﺕﺎﻋﻼﻃﺍ ،ﻲﻧﻮﻨﻛ ﺮﺼﻋ ﺭﺩ ﺡﺮﻄﻣ ﻭ ﻲﻠﻣ ﻪﻌﺳﻮﺗ ﻭ ﺪﺷﺭ ﻱﺍﺮﺑ ﻱﺭﻮﺘﻛﺎﻓ ،ﻲﻗﺮﺗ ﻭ ﺖﻓﺮﺸﻴﭘ ﺖﻳﻮﻨﻌﻣ ﻪﻤﺸﭼﺮﺳ ﺪﻧﺍﻮﺗ ﻲﻣ ﻪﻛ ﺖﺳﺍ ﻥﺎﻬﺟ ﺢﻄــﺳ ﺭﺩ ﻥﺪﺷ [1].ﺪﺷﺎﺑ ﺖّﻴﻘﻓﻮﻣ ﻭ ﺩﺭﻮﻣ ﻒﻠﺘﺨﻣ ﻱﺎﻫ ﻩﺯﻮﺣ ﺭﺩ ﺕﺎﻋﻼﻃﺍ ﻪﻛ ﺖــﺳﺍ ﻲﻬﻳﺪﺑ ﺖﻳﺮﻳﺪﻣ ﺰﻴﻧ ﻥﺎﻣﺭﺩ ﻭ ﺖﺷﺍﺪﻬﺑ ﻩﺯﻮﺣ ﺭﺩ ،ﺩﺮﻴﮔ ﻲﻣ ﺭﺍﺮﻗ ﻲﺳﺭﺮﺑ ﻥﺎﻣﺭﺩ ﻭ ﺖﺷﺍﺪﻬﺑ ﻪﻌﺳﻮﺗ ﺭﺩ ﻲﻤﻬﻣ ﺶﻘﻧ ﺖﻣﻼــﺳ ﺕﺎﻋﻼﻃﺍ ﻪﻌﺳﻮﺗ ﻢﻬﻣ ﺩﺎﻌﺑﺍ ﺯﺍ ﻲﻜﻳ ﻥﺍﻮﻨﻋ ﻪﺑ ﺖﻣﻼﺳ ﻡﺎﻈﻧ .ﺩﺭﺍﺩ ﺭﻮــﺸﻛ ﻲﻋﺎﻤﺘﺟﺍ ﻱﺎﻫ ﺖﺳﺎﻴﺳ ﻅﺎﺤﻟ ﻪﺑ ﻭ ﺩﻮﺷ ﻲﻣ ﺏﻮــﺴﺤﻣ ﻪﻌﻣﺎﺟ ﺭﺍﺩﺭﻮﺧﺮﺑ ﻲﻧﻭﺰﻓﺍﺯﻭﺭ ﺖﻴﻤﻫﺍ ﺯﺍ ﺭﻮﺸﻛ ﺮﻫ ﻱﺩﺎﺼﺘﻗﺍ ﺪــﺷﺭ ﻭ ﻱﺍﺮﺑ ﻪﻛ ﻲﻠﻣ ﺺﻟﺎﺧﺎﻧ ﺪﻴﻟﻮﺗ ﺪﺻﺭﺩ ﻲﻠﻠﻤﻟﺍ ﻦﻴﺑ ﺢﻄﺳ ﺭﺩ .ﺖﺳﺍ ﻝﺩﺎﻌﺘﻣﺎﻧ ﺭﺎﻴﺴﺑ ،ﺩﻮــﺷ ﻲﻣ ﻑﺮﺼﻣ ﻥﺎﻣﺭﺩ ﻭ ﺖــﺷﺍﺪﻬﺑ ﻦﻴﻣﺄﺗ ﺎﻫﺭﻮــﺸﻛ ﺢﻄــﺳ ﺭﺩ ﺪﺻﺭﺩ 15 ﺎﺗﺪﺻﺭﺩ 5 ﻦﻴﺑ ًﺎﺒﻟﺎﻏ ﻭ ﻩﺩﻮــﺑ ﻱﺩﺎﺼﺘﻗﺍ ﻪﻌــﺳﻮﺗ ﻩﺍﺭ ﺭﺩ ﻲﻌﻧﺎﻣ ﻱﺭﺎﻤﻴﺑ ﺭﻮــﻓﻭ .ﺖــﺳﺍ ﺮﻴﻐﺘﻣ 30-100 ﺍﺭ ﺩﺍﺮﻓﺍ ﻱﺪﻴﻟﻮﺗ ﻱﻭﺮﻴﻧ ﺪﻧﺍﻮﺗ ﻲﻣ ﻭ ﺖــﺳﺍ ﻲﻋﺎﻤﺘﺟﺍ ﻪﻌﺳﻮﺗ ﻭ ﻪﻌﻣﺎﺟ ﺩﺍﺮﻓﺍ ﺖﻣﻼــﺳ ﻭﺭ ﻦﻳﺍ ﺯﺍ .ﺪﻫﺩ ﺶﻫﺎﻛ ﺪﺻﺭﺩ ﻡﺎﻈﻧ ﺭﺩ ﻱﺭﺍﺬﮔ ﻪﻳﺎﻣﺮﺳ ﻡﺰﻠﺘﺴﻣ ﺎﻫﺭﻮﺸﻛ ﻲﻋﺎﻤﺘﺟﺍ ﻭ ﻱﺩﺎﺼﺘﻗﺍ [2].ﺪﺷﺎﺑ ﻲﻣ ﻥﺎﻣﺭﺩ ﻭ ﺖﺷﺍﺪﻬﺑ ﺕﺭﺍﺯﻭ ﻂﺳﻮﺗ 1378 ﻝﺎﺳ ﺭﺩ ﻩﺪﺷ ﺵﺭﺍﺰﮔ ﺭﺎﻣﺁ ﺱﺎﺳﺍ ﺮﺑ ﺮﻴﻣﻭ گﺮﻣ ﺖﻠﻋ ﻦﻳﺮﺘﻤﻬﻣ ﻲﻜﺷﺰﭘ ﺵﺯﻮﻣﺁ ﻭ ﻥﺎﻣﺭﺩ ،ﺖﺷﺍﺪﻬﺑ ﻩﺩﻮﺑ ﺪﺻﺭﺩ 20/14 ﺎﺑ ﻕﻭﺮــﻋ ﻭ ﺐﻠﻗ ﻱﺎﻫ ﻱﺭﺎﻤﻴﺑ ﺭﻮــﺸﻛ ﺭﺩ ﺯﺍ ﻲﻛﺎﺣ 2000 ﻝﺎﺳ ﺭﺩ ﺎﻜﻳﺮﻣﺍ ﺭﺩ ﺕﻮﻓ ﺭﺎﻣﺁ ﻦﻴﻨﭽﻤﻫ ،ﺖﺳﺍ ﻪﺒﺗﺭ ﺩﺭﻮﻣ 710760 ﺎﺑ ﻕﻭﺮﻋ ﻭ ﺐﻠﻗ ﻱﺎﻫ ﻱﺭﺎﻤﻴﺑ ﻪﻛ ﺖﺳﺍ ﻥﺁ [3].ﺖﺳﺍ ﻪﺘﺷﺍﺩ ﺍﺭ ﻝﻭﺍ ﺕﺎﻋﻼﻃﺍ ﺮﻴﺛﺄﺗ ﺖــﺤﺗ ﻱﺩﺎﻳﺯ ﺪﺣ ﺎــﺗ ﺖﻣﻼــﺳ ﺕﺎﻣﺪﺧ ﺩﻮﺒﻬﺑ ،ﺕﺎﻋﻼﻃﺍ ﻦﻳﺍ ﺵﺮﺘــﺴﮔ ﻭ ﺖــﺳﺍ ﻲﻧﺎﻣﺭﺩ ﻭ ﻲﺘــﺷﺍﺪﻬﺑ ﻢﺘﺴﻴﺳ .ﺩﺭﺍﺩ ﻝﺎﺒﻧﺩ ﻪﺑ ﺍﺭ ﺖﻣﻼﺳ ﺢﻄﺳ ءﺎﻘﺗﺭﺍ ﻭ ﺕﺎﻣﺪﺧ ﺖﻴﻔﻴﻛ ﻱﺪﻨﺑ ﻪﻘﺒﻃ ﻢﺘﺴﻴﺳ ﻚﻳ (DRG: Diagnosis Related Groups) ﻭ ﻲﺼﻴﺨــﺸﺗ ،ﻱﺩﺮﻓ ﺕﺎﺼﺨــﺸﻣ ﺎﺑ ﻂﺒﺗﺮﻣ ﻪﻛ ﺖــﺳﺍ ﺭﺎﻤﻴﺑ ﻭ ﻱﺮﺘﺴﺑ ﺕﺪﻣ ﻝﻮﻃ ﻪﺑ ﺖﺒــﺴﻧ ﻥﺍﺭﺎﻤﻴﺑ ﻲﻧﺎﻣﺭﺩ ﺕﺎﻴﺻﻮﺼﺧ ﻲﺑﻮﭼﺭﺎﭼ ^DRG ﻢﺘﺴﻴﺳ .ﺪﺷﺎﺑ ﻲﻣ ﻩﺪــﺷ ﻑﺮﺼﻣ ﻊﺑﺎﻨﻣ ﺭﺍﺪﻘﻣ ﺖﻬﺟ ﻪﻧﺎﮔﺪﻨﭼ ﺺﻴﺨﺸﺗ ﺎﺑ ﺹﺎﺧ ﻱﺮﺘــﺴﺑ ﺭﺎﻤﻴﺑ ﺮﻫ ﻱﺍﺮﺑ ﺍﺭ ﻞﻣﺎﺷ ﺎﻫ ﻩﻭﺮﮔ .ﺩﺭﻭﺁ ﻲﻣ ﻢﻫﺍﺮﻓ ﺕﺎﺣﺍﺮﺟ ﻭ ﻱﺭﺎﻤﻴﺑ ﻱﺪﻨﺑ ﻪﻘﺒﻃ ﻪﺑ ﻁﻮﺑﺮﻣ ﺎﻳ ﻪﻴﺒﺷ ﻲﻜﺷﺰﭘ ﺮﻈﻧ ﺯﺍ ﻪﻛ ﺪﻧﻮﺷ ﻲﻣ ﻲﻳﺎﻫ ﺺﻴﺨــﺸﺗ ﻩﺩﺎﻔﺘﺳﺍ ﻩﺪــﺷ ﻑﺮﺼﻣ ﻊﺑﺎﻨﻣ ﻉﻮﻧ ﻚﻳ ﺯﺍ ًﺎﺒﻳﺮﻘﺗ ﺎﻳ ﻭ ﺪﻨﺘــﺴﻫ ﻢﻫ

ﻲﺘﻟﻭﺩ ﻱﺎﻫ ﺶﺨﺑ ﺯﺍ ﻱﺩﺍﺪﻌﺗ ﺐﺨﺘﻨﻣ ﻱﺎﻫﺭﻮــﺸﻛ ﺭﺩ .ﺪﻧﺍ ﻩﺩﺮﻛ ﻱﺪﻨﺑ ﻪﻘﺒﻃ ﺯﺍ ﺖــﺷﺍﺪﻬﺑ ﺖﺒﻗﺍﺮﻣ ﻱﺎﻫ ﺡﺮﻃ ﺭﺩ ﻲــﺻﻮﺼﺧ ﻭ .ﺪﻨﻳﺎﻤﻧ ﻲﻣ ﻩﺩﺎﻔﺘﺳﺍ ﺮﮕﻧ ﻩﺪﻨﻳﺁ ﺖﺧﺍﺩﺮﭘ ﻢﺘﺴﻴﺳ ﻥﺍﻮﻨﻋ ﻪﺑ ^DRG ًﻻﻮﻤﻌﻣ ﺪﻧﺍ ﻩﺪــﺷ ﺺﺧﺮﻣ ﻥﺎﺘــﺳﺭﺎﻤﻴﺑ ﺯﺍ ﻪﻛ ﻱﺮﺘــﺴﺑ ﻥﺍﺭﺎﻤﻴﺑ ﺭﻮﻈﻨﻣ ﻪﺑ .ﺪﻧﻮــﺷ ﻲﻣ ﻱﺪﻨﺑ ﻪﻘﺒﻃ ^DRG ﻱﺎــﻫ ﻩﻭﺮﮔ ﻞــﺧﺍﺩ ﺭﺩ ﻥﺍﻮﺗ ﻲﻣ ،ﺮﮕﻧ ﻩﺪﻨﻳﺁ ﺖﺧﺍﺩﺮﭘﺯﺎﺑ ﻢﺘﺴﻴﺳ ﺖﺤﺗ ﻪﻨﻳﺰﻫ ﺖﺧﺍﺩﺮﭘ ﻩﺪﺷ ﻡﺎﺠﻧﺍ ﻲﺣﺍﺮﺟ ﻡﺍﺪﻗﺍ 6 ﻭ ﻲﻠﺻﺍ ﺺﻴﺨﺸﺗ 8 ﺎﺗ ﻱﺪﻨﺑ ﻪﻘﺒﻃ ﻭ ﺲﻨﺟ ،ﻦﺳ ﻥﺁ ﺮﺑ ﻩﻭﻼﻋ .ﺩﻮﻤﻧ ﻪﺒﺳﺎﺤﻣ ﺍﺭ ﺭﺎﻤﻴﺑ ﺖﻣﺎﻗﺍ ﻲﻃ ﺭﺩ ﺪﻛ ﻦﻴﻴﻌﺗ ﺭﺩ ﺖﺳﺍ ﻦﻜﻤﻣ ﺰﻴﻧ ﺺﻴﺧﺮﺗ ﻡﺎﮕﻨﻫﺭﺩ ﺭﺎﻤﻴﺑ ﺖﻴﻌﺿﻭ ﻲﺼﻴﺨﺸﺗ ﻱﺎﻫ ﻩﺩﺭ ،ﻢﺘﺴﻴﺳ ﻦﻳﺍ ﺭﺩ .ﺩﻮﺷ ﻪﺘﻓﺮﮔ ﺮﻈﻧ ﺭﺩ ^DRG .ﺪﻧﺭﺍﺩ ﻲﻤﻬﻣ ﺶﻘﻧ (MDC: Major Diagnosis Categories) ﻩﺪﻨﻨﻛ ﺲﻜﻌﻨﻣ ﻪﻛ ﺖــﺳﺍ ﻲﺒــﺴﻧ ﺵﺯﺭﺍ ﻚﻳ ﻱﺍﺭﺍﺩ ^DRG ﺮﻫ ﺭﺎﻤﻴﺑ ﻱﺍﺮﺑ ﻩﺪــﺷ ﻑﺮﺼﻣ ﺕﺍﺰﻴﻬﺠﺗ ﻭ ﺕﺎﻣﺪﺧ ﻪــﻴﻠﻛ ﻪــﻨﻳﺰﻫ ﻲﻓﺮﺼﻣ ﻊﺑﺎﻨﻣ ﻥﺍﺰﻴﻣ ﻩﺪﻨﻫﺩ ﻥﺎﺸﻧ ،ﺮﺗﻻﺎﺑ ﻲﺒﺴﻧ ﺵﺯﺭﺍ .ﺪﺷﺎﺑ ﻲﻣ ﺮﻫ ﻱﺍﺮﺑ ﻲﺒﺴﻧ ﺵﺯﺭﺍ .ﺖﺳﺍ ﺮﺗﻻﺎﺑ ﺖﺧﺍﺩﺮﭘ ﻪﺠﻴﺘﻧ ﺭﺩ ﻭ ﺮﺘﺸﻴﺑ ﺎﻣﺍ ﺪﺷﺎﺑ ﻲﻣ ﻥﺎﺴﻜﻳ ﻪﺑﺎﺸﻣ ﻱﺎﻫ ﻥﺎﺘــﺳﺭﺎﻤﻴﺑ ﻡﺎﻤﺗ ﺭﺩ ^DRG ﺪﻛ ﺖﺳﺍ ﺩﻮﺧ ﺹﺎﺧ ﻲﻟﻮﭘ ﻪﺒﺳﺎﺤﻣ ﺭﺎﻴﻌﻣ ﻱﺍﺭﺍﺩ ﻲﻧﺎﺘــﺳﺭﺎﻤﻴﺑ ﺮﻫ ﻲﺒﻴﻛﺮﺗ ﻪﺟﺭﺩ ﻦﻳﺍ .ﺩﻮﺷ ﻲﻣ ﻥﺎﺘــﺳﺭﺎﻤﻴﺑ ﻥﺁ ﻪﺟﺭﺩ ﻪﺑ ﻁﻮﺑﺮﻣ ﻪﻛ ﺭﻮﻣﺍ ﻩﺭﺍﺩﺍ ﻂﺳﻮﺗ ﻪﻛ ﺖﺳﺍ ﻩﺪــﺸﻧ ﺎﻳ ﻩﺪــﺷ ﻡﺎﺠﻧﺍ ﻱﺎﻫ ﻪﻨﻳﺰﻫ ﺯﺍ

HCFA: Health Care Financial) ﻲﺘــﺷﺍﺪﻬﺑ ﺖﺒﻗﺍﺮﻣ ﻲــﻟﺎﻣ [4].ﺖﺳﺍ ﻩﺪﺷ ﻦﻴﻴﻌﺗ ﻪﻴﺣﺎﻧ ﻥﺁ ﻱﺍﺮﺑ (Administration

،ﺩﺭﺍﺩ ﻢﻬﻣ ﺖﻳﺰﻣ ﻭﺩ ﺖﺧﺍﺩﺮﭘ ﺯﺎﺑ ﺭﺎﻨﻛ ﺭﺩ ^DRG ﻢﺘــﺴﻴﺳ ﻪﺑ ﻪﻛ ﻲﺋﺎﺠﻧﺁ ﺯﺍ .ﺖــﺳﺍ ﺖﺒﻗﺍﺮﻣ ﺖﻴﻔﻴﻛ ﻲﺑﺎﻳﺯﺭﺍ ،ﺖﻳﺰﻣ ﻦﻴﻟﻭﺍ ،ﺪﻨﻛ ﻲﻣ ﺍﺪﻴﭘ ﺹﺎﺼﺘﺧﺍ ^DRG ﺪﻛ ﻚﻳ ﻲﻨﻴﻟﺎﺑ ﻪﺑﺎﺸﻣ ﺩﺭﺍﻮﻣ ﻡﺎﻤﺗ ﻊﻳﺯﻮﺗ ،ﻥﺎﻣﺭﺩ ﻱﺎﻫ ﻞﻜﺗﻭﺮﭘ ﻞﻴﻠﺤﺗ ﻭ ﻪﻳﺰﺠﺗ ﻥﺍﻮﺗ ﻲﻣ ﻪﺠﻴﺘﻧ ﺭﺩ ﻭ ﻪﻳﺰﺠﺗ ﺞﻳﺎﺘﻧ .ﺩﺍﺩ ﻡﺎﺠﻧﺍ ﺍﺭ ﻪﺘــﺴﺑﺍﻭ ﻂﻳﺍﺮــﺷ ﻭ ﻱﺭﺎﻣﺁ ﺮﺻﺎﻨﻋ ﻭ ﻥﺍﺭﺍﺬﮔﺪﻛ ،ﻥﺎﻜــﺷﺰﭘ ﺵﺯﻮﻣﺁ ﺖﻓﺮــﺸﻴﭘ ﺭﺩ ^DRG ﻞﻴﻠﺤﺗ ﻩﺩﺎﻔﺘﺳﺍ ﺩﺭﻭﺎﺘﺳﺩ ﻭ ﺖﻳﺰﻣ ﻦﻴﻣﻭﺩ .ﺪــﺷﺎﺑ ﻲﻣ ﺮﺛﺆﻣ ﻥﺍﺭﺎﺘــﺳﺮﭘ ﺮﻫ .ﺖﺳﺍ ﺕﺎﻣﺪﺧ ﺯﺍ ﻱﺭﺍﺩﺮﺑ ﻩﺮﻬﺑ ﻲﺑﺎﻳﺯﺭﺍ ^DRG ﻢﺘــﺴﻴﺳ ﺯﺍ ﻥﺎــﺸﻧ ﺍﺭ ﻥﺍﺭﺎﻤﻴﺑ ﻪﺠﻟﺎﻌﻣ ﻱﺍﺮﺑ ﺯﺎﻴﻧ ﺩﺭﻮﻣ ﻊﺑﺎﻨﻣ ﻝﺪــﻌﻣ ^DRG

DRG ﺮﻫ ﻱﺍﺮﺑ ﻥﺎﺘﺳﺭﺎﻤﻴﺑ ﺖﺧﺍﺩﺮﭘ ﻪﺒﺳﺎﺤﻣ ﻝﻮﻣﺮﻓ .ﺪﻫﺩ ﻲﻣ :ﺪﺷﺎﺑ ﻲﻣ ﺮﻳﺯ ﺕﺭﻮﺻ ﻪﺑ ﺖﺧﺍﺩﺮﭘ =ﻥﺎﺘــﺳﺭﺎﻤﻴﺑ ﻪﻳﺎﭘ ﺥﺮﻧ * ^DRG ﻪﺑ ﻪﺘــﺴﺑﺍﻭ ﺵﺯﺭﺍ [5].ﻥﺎﺘﺳﺭﺎﻤﻴﺑ

(3)

(37) 12 ؛1388 ﺖﻣﻼﺳ ﺖﻳﺮﻳﺪﻣ

ﻢﺘﺴﻴﺳ ﺯﺍ ﻩﺪــﺷ ﻪﺋﺍﺭﺍ ﺕﺎﻣﺪﺧ ﻪﻨﻳﺰﻫ ﺩﺭﻭﺁﺮﺑ ﻱﺍﺮﺑ ﻥﺍﺮﻳﺍﺭﺩ .ﺩﻮﺷ ﻲﻣ ﻩﺩﺎﻔﺘﺳﺍ ﺎﻴﻧﺮﻔﻴﻟﺎﻛ ﺏﺎﺘﻛ ﺎﻳ ﺎﻜﻳﺮﻣﺍ ﺩﺭﺍﺪﻧﺎﺘﺳﺍ ﻱﺭﺍﺬﮕﻣﺎﻧ ﺕﺭﻮﺻ ﻪﺑ ﻪﻛ ﺕﺎﻣﺪﺧ ﻪﺑ ﻪﺘﺴﺑﺍﻭ ﻱﺎﻫ ﺵﺯﺭﺍ ﺯﺍ ﻢﺘﺴﻴﺳ ﻦﻳﺍ ﺭﺩ ﻢﺘﺴﻴﺳ ﻦﻳﺍ ﺭﺩ .ﺩﻮﺷ ﻲﻣ ﻩﺩﺎﻔﺘﺳﺍ ،ﺖﺳﺍ ﻩﺪﺷ ﻪﺋﺍﺭﺍ ﺹﺎﺧ ﺐﻳﺍﺮﺿ ﻩﺪﺷ ﻪﺋﺍﺭﺍ ﺕﺎﻣﺪﺧ ﻪﺑ ﻁﻮﺑﺮﻣ ﺕﺎﻋﻼﻃﺍ ﺖﺒﺛ ﻱﺍﺮﺑ ^K ﺐﻳﺍﺮﺿ ﺯﺍ ﻭ ﺎﺒﻔﻟﺍ ﻑﺮﺣ ﻚﻳ ﺎﺑ ﻢﺘﺴﻴﺳ ﻦﻳﺍ ﺭﺩ ﺪﻛ .ﺩﻮﺷ ﻲﻣ ﻩﺩﺎﻔﺘﺳﺍ ﺭﺎﻤﻴﺑ ﻪﺑ ﻥﺎﺸﻧ ﺭﺎﺸﻋﺍ ﺯﺍ ﺪﻌﺑ ﻢﻗﺭ ﻭﺩ ﻥﺁ ﻝﺎﺒﻧﺩ ﻪﺑ ﻭ ﺩﻮﺷ ﻲﻣ ﻉﻭﺮﺷ ﻢﻗﺭ ﻪﺳ ﻡﺎﻈﻧ ﺭﺩ ﻱﺰﻳﺭ ﻪﻣﺎﻧﺮﺑ ﻱﺍﺮﺑ [6].ﺪــﺷﺎﺑ ﻲﻣ ﻪﻋﻮﻤﺠﻣ ﺮﻳﺯ ﻩﺪﻨﻫﺩ ﻦﺘﺷﺍﺩ ،ﻩﺪﺷ ﻪﺋﺍﺭﺍ ﺕﺎﻣﺪﺧ ﻪﺑ ﻪﺟﻮﺗ ﺎﺑ ﺖﺧﺍﺩﺮﭘﺯﺎﺑ ﻭ ﺖﺧﺍﺩﺮﭘ ﻱﺎﻫ ﻱﺭﺎﻤﻴﺑ ﺕﺎﻣﺪﺧ ﺖﺒﺛ ﺭﺩ ﻖﻴﻗﺩ ﻭ ﺖــﺳﺭﺩ ﻲﺗﺎﻋﻼﻃﺍ ﻡﺎﻈﻧ ﻪﺟﻮﺗ ﺎﺑ .ﺪﻨﻛ ﻲﻣ ﺎﻔﻳﺍ ﻲﻤﻬﻣ ﺶﻘﻧ ﺎﻫ ﻩﺩﺍﺩ ﻞﻴﻠﺤﺗ ﻭ ﻕﻭﺮﻋ ﻭ ﺐﻠﻗ ﻥﺎﻣﺭﺩ ﻭ ﺖﺷﺍﺪﻬﺑ ﻡﺎﻈﻧ ﺭﺩ ﻕﻭﺮﻋ ﻭ ﺐﻠﻗ ﻱﺎﻫ ﻱﺭﺎﻤﻴﺑ ﺖﻴﻤﻫﺍ ﻪﺑ ﻲﺼﻴﺨﺸﺗ ﻱﺎﻫ ﻩﻭﺮﮔ ﻢﺘﺴﻴﺳ ﻪﻨﻴﻣﺯ ﺭﺩ ﻲــﺸﻫﻭﮋﭘ ﻡﺎﺠﻧﺍ ﻥﺍﺮﻳﺍ ﺎﺑ ﻥﺁ ﻪــﺴﻳﺎﻘﻣ ﻭ ﺐﺨﺘﻨﻣ ﻱﺎﻫﺭﻮــﺸﻛ ﺭﺩ ﻕﻭﺮﻋ ﻭ ﺐﻠﻗ ﻂﺒﺗﺮﻣ ﻪﺠﻴﺘﻧ ﺖﺳﺍ ﻲﻬﻳﺪﺑ .ﺪﺷﺎﺑ ﻲﻣ ﻱﺭﻭﺮﺿ ﻥﺍﺮﻳﺍ ﺭﺩ ﺩﻮﺟﻮﻣ ﻂﻳﺍﺮﺷ ﺩﺎﺠﻳﺍ ﺭﺩ ﺮﺛﺆﻣ ﻱﺎﻫﺭﺎﻜﻫﺍﺭ ﻪﺋﺍﺭﺍ ﻖﻳﺮﻃ ﺯﺍ ﺪﻧﺍﻮﺗ ﻲﻣ ﺶﻫﻭﮋﭘ ﻦﻳﺍ ﻭ ﺐﻠﻗ ﻱﺎﻫ ﻱﺭﺎﻤﻴﺑ ﻂﺒﺗﺮﻣ ﻲﺼﻴﺨﺸﺗ ﻱﺎﻫ ﻩﻭﺮﮔ ﻲﻠﻣ ﻢﺘــﺴﻴﺳ ﺖﻣﻼﺳ ﺕﺎﻋﻼﻃﺍ ﻡﺎﻈﻧ ءﺎﻘﺗﺭﺍﻭ ﻩﺪﺷ ﻊﻗﺍﻭ ﺮﺛﺆﻣ ﻥﺍﺮﻳﺍ ﺭﺩ ﻕﻭﺮﻋ .ﺪﺷﺎﺑ ﻪﺘﺷﺍﺩ ﻝﺎﺒﻧﺩ ﻪﺑ ﺍﺭ ﻪﻌﻣﺎﺟ ﺭﺩ ﻲﺳﺭﺮﺑ ﺵﻭﺭ -87ﻝﺎﺳ ﺭﺩ ﻱﺍ ﻪــﺴﻳﺎﻘﻣ -ﻲﻔﻴﺻﻮﺗ ﺵﻭﺭ ﻪﺑ ﺮﺿﺎﺣ ﺶﻫﻭﮋﭘ ﻲﺼﻴﺨﺸﺗ ﻱﺎﻫ ﻩﻭﺮﮔ ﻢﺘﺴﻴﺳ ﺍﺪﺘﺑﺍ .ﺖــﺳﺍ ﻩﺪــﺷ ﻡﺎﺠﻧﺍ 1386 ﺐﺨﺘﻨﻣ ﻱﺎﻫﺭﻮــﺸﻛ ﺭﺩ ﻕﻭﺮﻋ ﻭ ﺐﻠﻗ ﻱﺎــﻫ ﻱﺭﺎﻤﻴﺑ ﻂــﺒﺗﺮﻣ ﻲﺳﺭﺮﺑ ﻦﻳﺍ .ﺪﺷ ﻲﺳﺭﺮﺑ (ﺍﺩﺎﻧﺎﻛ ﻭ ﺎﻴﻟﺍﺮﺘــﺳﺍ ،ﺲﻴﻠﮕﻧﺍ ،ﺎﻜﻳﺮﻣﺍ) ﻩﺩﻮﺑ ﺖﻧﺮﺘﻨﻳﺍ ﻭ ﺕﺎﻳﺮــﺸﻧ ،ﺎــﻫ ﺏﺎﺘﻛ ﺭﺩ ﻮﺠﺘــﺴﺟ ﻖــﻳﺮﻃ ﺯﺍ ﺩﻮﺟﻮﻣ ﺕﺎﻋﻼﻃﺍ ﺯﺍ ﻩﺩﺎﻔﺘﺳﺍ ﺎﺑ ﺎﻫ ﻢﺘــﺴﻴﺳ ﻦﻳﺍ ﻞﻴﻠﺤﺗ .ﺖــﺳﺍ ﺶﻫﻭﮋﭘ ﻪــﻌﻣﺎﺟ .ﺖﻓﺮﻳﺬﭘ ﻡﺎــﺠﻧﺍ ﻱﺍ ﻪــﺴﻳﺎﻘﻣ ﻝﻭﺍﺪــﺟ ﺭﺩ ﺯﺍ ﻪﻛ ﺪﻨﺘﺴﻫ ﺍﺩﺎﻧﺎﻛ ﻭ ﺲﻴﻠﮕﻧﺍ ،ﺎﻴﻟﺍﺮﺘــﺳﺍ ،ﺎﻜﻳﺮﻣﺍ ﻱﺎﻫﺭﻮــﺸﻛ ﺐﻠﻗ ﻱﺎﻫ ﻱﺭﺎﻤﻴﺑ ^DRG ﻢﺘﺴﻴﺳ ﻪﻨﻴﻣﺯ ﺭﺩ ﻭﺮﺸﻴﭘ ﻱﺎﻫﺭﻮــﺸﻛ ﺞﻳﺍﺭ ﻲﺴﻴﻠﮕﻧﺍ ﻥﺎﺑﺯ ﻲﻓﺮﻃ ﺯﺍ ﻭ ﺪﻧﻮﺷ ﻲﻣ ﺏﻮــﺴﺤﻣ ﻕﻭﺮﻋ ﻭ ﺭﺩ .ﺪﻨﻛ ﻲﻣ ﺮــﺴﻴﻣ ﺍﺭ ﺕﺎﻋﻼﻃﺍ ﻝﺩﺎﺒﺗ ﻥﺎﻜﻣﺍ ﺎﻫﺭﻮــﺸﻛ ﻦﻳﺍ ﺭﺩ ﻭ ﺐﻠﻗ ﻱﺎﻫ ﻱﺭﺎﻤﻴﺑ ﻪﺑ ﻁﻮﺑﺮﻣ ﺚﺣﺎﺒﻣ ﻭ ﻝﻮﺼﻓ ﺶﻫﻭﮋﭘ ﻦــﻳﺍ (ﺎﻴﻧﺮﻔﻴﻟﺎﻛ ﺏﺎﺘﻛ) ﺎﻜﻳﺮﻣﺍ ﺩﺭﺍﺪﻧﺎﺘﺳﺍ ﻱﺭﺍﺬﮕﻣﺎﻧ ﺏﺎﺘﻛ ﺭﺩ ﻕﻭﺮﻋ .ﺖﺳﺍ ﻩﺪﺷ ﻲﺳﺭﺮﺑ ﺰﻴﻧ ﻥﺍﺮﻳﺍ ﺭﻮﺸﻛ ﺭﺩ ﺎﻫ ﻪﺘﻓﺎﻳ

،ﺎﻜﻳﺮﻣﺍ) ﺐﺨﺘﻨﻣ ﻱﺎﻫﺭﻮﺸﻛ ﻪﻴﻠﻛ ﺭﺩ ﻪﻛ ﺪﻨﻫﺩ ﻲﻣ ﻥﺎﺸﻧ ﺎﻫ ﻪﺘﻓﺎﻳ ﻱﺎﻫ ﻱﺭﺎﻤﻴﺑ ^DRG ﻲﻠﻣ ﻢﺘﺴﻴﺳ ﺯﺍ (ﺍﺩﺎﻧﺎﻛ ﻭ ﺲﻴﻠﮕﻧﺍ ،ﺎﻴﻟﺍﺮﺘﺳﺍ ﺐﺨﺘﻨﻣ ﻱﺎﻫﺭﻮــﺸﻛ ﻡﺎﻤﺗ ﺭﺩ .ﺪﻨﻨﻛ ﻲﻣ ﻩﺩﺎﻔﺘــﺳﺍ ﻕﻭﺮﻋ ﻭ ﺐﻠﻗ ﻕﻭﺮﻋ ﻭ ﺐﻠﻗ ﻱﺎﻫ ﻱﺭﺎﻤﻴﺑ ^DRG ﻢﺘــﺴﻴﺳ ﻝﻮﺌﺴﻣ ﻥﺎﻣﺯﺎــﺳ ﻪﻨﻳﺰﻫ ﺩﺭﻭﺁﺮﺑ ﻢﺘﺴﻴﺳ ﺕﺎﻴﺻﻮﺼﺧ 1 ﻝﻭﺪﺟ .ﺩﻮــﺷ ﻲﻣ ﻩﺪﻳﺩ ﻢﺘــﺴﻴﺳ ﺭﺩ ﺎﻫﺪﻛ .ﺪﻫﺩ ﻲﻣ ﻥﺎــﺸﻧ ﺐﺨﺘﻨﻣ ﻱﺎﻫﺭﻮــﺸﻛ ﺭﺩ ﺍﺭ ﻪﺑ ﺐﺨﺘﻨﻣ ﻱﺎﻫﺭﻮــﺸﻛ ﻕﻭﺮﻋ ﻭ ﺐــﻠﻗ ﻱﺎــﻫ ﻱﺭﺎﻤﻴﺑ ^DRG

DRG ﻱﺎﻫﺪﻛ ﻪﻧﻮﻤﻧ 2 ﻝﻭﺪﺟ .ﺖﺳﺍ ﻱﺩﺪﻋ -ﻲﻳﺎﺒﻔﻟﺍ ﻞﻜــﺷ ﺐﺨﺘﻨﻣ ﻱﺎﻫﺭﻮــﺸﻛ ﻡﺎﻤﺗ ﺭﺩ .ﺪــﻫﺩ ﻲﻣ ﻥﺎــﺸﻧ ﺎﻜــﻳﺮﻣﺍ ﺭﺩ ﺍﺭ ﺮﺑ ﻢﻛﺎﺣ ﺕﺍﺭﺮﻘﻣ ﻭ ﻦــﻴﻧﺍﻮﻗ ﺮﺑ ﺮﻇﺎﻧ ﻭ ﻱﺮــﺠﻣ ﻱﺎﻫ ﻥﺎﻣﺯﺎــﺳ ﻦﻴﻧﺍﻮﻗ ﺖﻳﺎﻋﺭ .ﺪــﻧﺭﺍﺩ ﺩﻮﺟﻭ ﻕﻭﺮﻋ ﻭ ﺐــﻠﻗ ^DRG ﻢﺘــﺴﻴﺳ ﻑﺮﻃ ﺯﺍ ﻩﺪــﺷ ﻦﻴﻴﻌﺗ ﻱﺎﻫﺩﺭﺍﺪﻧﺎﺘــﺳﺍ ﻭ ﻥﺩﺮﻛ ﻲﻣﻮﺑ ﻪﺑ ﻁﻮﺑﺮﻣ ،ﺎﻫ ﻩﺩﺍﺩ ﻝﺩﺎﺒﺗ ﻪﺑ ﻁﻮﺑﺮﻣ ﻦﻴﻧﺍﻮﻗ ﻦﻴﻨﭽﻤﻫ ،ﻂﺑﺮﻳﺫ ﻱﺎﻫ ﻥﺎﻣﺯﺎﺳ

DRG ﻢﺘﺴﻴﺳ ﺭﺩ ﺕﺎﻋﻼﻃﺍ ﻥﺪﺷ ﺯﻭﺭ ﻪﺑ ﺪﻧﻭﺭ ﻭ ﻱﺮﻳﺬﭘ ﻪﻌﺳﻮﺗ ﻪﻌﺳﻮﺗ ﺭﺩ ﺎﻫ ﻥﺎﻣﺯﺎﺳ ﻦﻳﺍ .ﺩﻮﺷ ﻲﻣ ﻩﺪﻳﺩ ﺐﺨﺘﻨﻣ ﻱﺎﻫﺭﻮــﺸﻛ ﻲﺷﺯﻮﻣﺁ ﺕﺎﺴﻠﺟ ﻱﺭﺍﺰﮔﺮﺑ ،ﻱﺭﺍﺬﮔﺪﻛ ﻱﺎﻫﺩﺭﺍﺪﻧﺎﺘﺳﺍ ﻡﻭﺍﺪﻣ ءﺎﻘﺗﺭﺍ ،ﻲﺘــﺷﺍﺪﻬﺑ ﺕﺎﻋﻼﻃﺍ ﻭ ﺭﺎﻣﺁ ﻱﺭﻭﺁ ﻊﻤﺟ ،ﺎﻫ ﺲﻧﺍﺮﻔﻨﻛ ﻭ ﻝﺩﺎﺒﺗ ﺖﻴﻠﺑﺎﻗ ،ﺎﻫ ﻩﺩﺍﺩ ﺖﻴﻔﻴﻛ ﺩﻮﺒﻬﺑ ﻖﻳﺮﻃ ﺯﺍ ﺖﺷﺍﺪﻬﺑ ﺢﻄــﺳ ﻱﺎﻫ ﻥﺎﻣﺯﺎﺳ ﺐﺨﺘﻨﻣ ﻱﺎﻫﺭﻮﺸﻛ ﻪﻴﻠﻛ ﺭﺩ .ﺪﻧﺭﺍﺩ ﺖﻴﻟﺎﻌﻓ ﺎﻫ ﻩﺩﺍﺩ ﻲﻳﺎﻫ ﻲﮔﮋﻳﻭ ﺩﻮﺷ ﻲﻣ ﻩﺪﻳﺩ ﻱﺯﺎﺳ ﺪﻣﺁﺯﻭﺭ ﻭ ﺵﺯﻮﻣﺁ ﻝﻮﺌــﺴﻣ ﺯﺍ ﺵﺯﻮﻣﺁ :ﻞﻣﺎﺷ ﺩﻮﺷ ﻲﻣ ﻩﺪﻳﺩ ﺐﺨﺘﻨﻣ ﻱﺎﻫﺭﻮﺸﻛ ﻪﻴﻠﻛ ﺭﺩ ﻪﻛ ﻦﻴﺼﺼﺨﺘﻣ ﺖﻴﺑﺮﺗ ،ﻪﻧﺎﻴﻟﺎﺳ ﺵﺯﻮﻣﺁ ﻱﺪﻨﺒﻧﺎﻣﺯ ﻝﻭﺪﺟ ،ﺭﻭﺩ ﻩﺍﺭ ﺪﻣﺁﺯﻭﺭ ﻝﺎﻌﻓ ﺪﻧﻭﺭ ﻭ ﻲﻨﻴﻟﺎﺑ ﻦﻴﺼﺼﺨﺘﻣ ﺎﺑ ﻩﺭﻭﺎﺸﻣ ،ﻱﺭﺍﺬﮔﺪﻛ [7-14].ﺩﺮﺑ ﻡﺎﻧ ﺍﺭ ﻱﺯﺎﺳ ﺪﻗﺎﻓ ﻥﺍﺮﻳﺍ ﻪــﻛ ﺖــﺳﺍ ﻥﺁ ﻩﺪﻨﻫﺩ ﻥﺎــﺸﻧ ﻥﺍﺮﻳﺍ ﻱﺎــﻫ ﻪﺘﻓﺎﻳ ﺎﻜﻳﺮﻣﺍ ﺩﺭﺍﺪﻧﺎﺘﺳﺍ ﻱﺭﺍﺬﮕﻣﺎﻧ ﺏﺎﺘﻛ ﺯﺍ ﻭ ﺖــﺳﺍ ^DRG ﻢﺘــﺴﻴﺳ ﻢﺘﺴﻴﺳ ﺯﺍ ﻩﺩﺎﻔﺘﺳﺍ ﻥﺍﺮﻳﺍ ﺭﺩ .ﺩﻮﺷ ﻲﻣ ﻩﺩﺎﻔﺘﺳﺍ (ﺎﻴﻧﺮﻔﻴﻟﺎﻛ ﺏﺎﺘﻛ) ﻩﺪــﺷ ﻪﺋﺍﺭﺍ ﺕﺎﻣﺪﺧ ﺖﺧﺍﺩﺮﭘﺯﺎﺑ ﻭ ﺖﺧﺍﺩﺮﭘ ﻡﺎﻈﻧ ﻱﺍﺮﺑ ^DRG ﻝﻮﺌﺴﻣ ﻥﺎﻣﺯﺎــﺳ .ﺩﻮــﺷ ﻲﻤﻧ ﻩﺪﻳﺩ ﻕﻭﺮﻋ ﻭ ﺐﻠﻗ ﻱﺎﻫ ﻱﺭﺎﻤﻴﺑ ﻥﺍﺮﻳﺍ ﺭﺩ ﻕﻭﺮﻋ ﻭ ﺐــﻠﻗ ﻱﺎﻫ ﻱﺭﺎﻤﻴﺑ ﻪﻨﻳﺰﻫ ﺩﺭﻭﺁﺮﺑ ﻢﺘــﺴﻴﺳ ﻝﻭﺪﺟ ،ﺭﻭﺩ ﻩﺍﺭ ﺯﺍ ﺵﺯﻮﻣﺁ ﺪﻨﻧﺎﻣ ﻲﻳﺎﻫ ﻲﮔﮋﻳﻭ ﻭ ﻪﺘﺷﺍﺪﻧ ﺩﻮﺟﻭ ،ﻱﺭﺍﺬﮔﺪﻛ ﻦﻴﺼﺼﺨﺘﻣ ﺖﻴﺑﺮﺗ ،ﻪﻧﺎﻴﻟﺎــﺳ ﺵﺯﻮﻣﺁ ﻱﺪﻨﺒﻧﺎﻣﺯ ﺭﺩ ﻱﺯﺎﺳ ﺪﻣﺁﺯﻭﺭ ﻝﺎﻌﻓ ﺪﻧﻭﺭ ﻭ ﻲﻨﻴﻟﺎﺑ ﻦﻴﺼﺼﺨﺘﻣ ﺎﺑ ﻩﺭﻭﺎــﺸﻣ .ﺖﺳﺍ ﻩﺪﺸﻧ ﻲﻨﻴﺑ ﺶﻴﭘ ﻥﺍﺮﻳﺍ

(4)

(37) 12 ؛1388 ﺖﻣﻼﺳ ﺖﻳﺮﻳﺪﻣ

ﻱﺮﻴﮔ ﻪﺠﻴﺘﻧ ﻭ ﺚﺤﺑ ﻱﺮﻴﮔ ﻪﺠﻴﺘﻧ ﻥﺍﻮﺗ ﻲﻣ ﺶﻫﻭﮋﭘ ﻱﺎﻫ ﻪﺘﻓﺎﻳ ﺱﺎﺳﺍ ﺮﺑ ﻲﻠﻛ ﺭﻮﻃ ﻪﺑ ﻱﺎﻫﺯﺎﻴﻧ ،ﻦﻴﻧﺍﻮﻗ ،ﻑﺍﺪﻫﺍ ﺱﺎﺳﺍ ﺮﺑ ﺐﺨﺘﻨﻣ ﻱﺎﻫﺭﻮﺸﻛ ﻪﻛ ﺩﺮﻛ ﺖﻬﺟ ﺭﺩ ﺍﺭ ^DRG ﻲﻠﻣ ﻢﺘﺴﻴﺳ ﻲﺘﺷﺍﺪﻬﺑ ﻱﺎﻫﺩﺭﺍﺪﻧﺎﺘﺳﺍ ﻭ ﻲﻠﻣ ﺩﺎﺠﻳﺍ ﻕﻭﺮﻋ ﻭ ﺐــﻠﻗ ﻱﺎﻫ ﻱﺭﺎﻤﻴﺑ ﻩﺪــﺷ ﻪﺋﺍﺭﺍ ﺕﺎﻣﺪﺧ ﺖــﺒﺛ ،ﺲﻴﻠﮕﻧﺍ ﻱﺎﻫﺭﻮــﺸﻛ ﺭﺩ ^DRG ﻢﺘــﺴﻴﺳ ﻊﻗﺍﻭ ﺭﺩ .ﺪــﻧﺍ ﻩﺩﻮﻤﻧ ﺎﺑ.ﺖﺳﺍ ﺎﻜﻳﺮﻣﺍ ^DRG ﻩﺪــﺷ ﻲﻣﻮﺑ ﻪﺨــﺴﻧ ،ﺍﺩﺎﻧﺎﻛ ﻭ ﺎﻴﻟﺍﺮﺘــﺳﺍ ﺪﻳﺪﺟ ﻢﺘــﺴﻴﺳ ﻚﻳ ﺩﺎﺠﻳﺍ ﻭ ﻲﺣﺍﺮﻃ ﻪﻛ ﻪــﺘﻜﻧ ﻦﻳﺍ ﻪﺑ ﻪــﺟﻮﺗ ﻥﻭﺪﺑ ﺎﻫﺭﻮﺸﻛ ﻦﻳﺍ ،ﺪــﺷﺎﺑ ﻲﻣ ﻪﻨﻳﺰﻫ ﻭ ﺖﻗﻭ ﻑﺮﺻ ﻡﺰﻠﺘــﺴﻣ ﺭﺩ ﻲﻟﺎﻣ ﻱﺎﻫ ﺖﺳﺎﻴﺳ ﻪﺑ ﻪﺟﻮﺗ ﺎﺑ ^DRG ﻲﻠﺻﺍ ﺭﺎﺘﺧﺎﺳ ﺭﺩ ﺮﻴﻴﻐﺗ ﻱﺎﻫ ﺖﺳﺎﻴﺳ ﻭ ﺕﺎﻣﺪﺧ ﻪﺋﺍﺭﺍ ﺪﻧﻭﺭ ،ﻥﺎﻣﺭﺩ ﻭ ﺖــﺷﺍﺪﻬﺑ ﻪﻨﻴﻣﺯ ﺩﺭﻮﻣ ﻱﺎﻫ ﻪﻨﻴﻣﺯ ﺭﺩ ﺕﺎﺣﻼﺻﺍ ﻡﺎﺠﻧﺍ ﻪﺑ ﻡﺍﺪﻗﺍ ﻪﻤﻴﺑ ﻱﺎﻫ ﺖﻛﺮﺷ

.ﺪﻧﺍ ﻩﺩﺮﻛ ﺮﻈﻧ ﺏﺎﺘﻛ ﺎﻳ ﺎﻜﻳﺮﻣﺍ ﺩﺭﺍﺪﻧﺎﺘﺳﺍ ﻱﺭﺍﺬﮕﻣﺎﻧ ﻢﺘــﺴﻴﺳ ﺯﺍ ﻥﺍﺮﻳﺍﺭﺩ ﻩﺪــﺷ ﻪﺋﺍﺭﺍ ﺕﺎﻣﺪﺧ ﻲﺒــﺴﻧ ﺵﺯﺭﺍ ﺩﺭﻭﺁﺮﺑ ﺭﻮﻈﻨﻣ ﻪﺑ ﺎﻴﻧﺮﻔﻴﻟﺎﻛ ﻩﺩﻮﺑ ﻱﺩﻼﻴﻣ 50 ﻪﻫﺩ ﻪﺑ ﻖﻠﻌﺘﻣ ﻢﺘﺴﻴﺳ ﻦﻳﺍ .ﺩﻮﺷ ﻲﻣ ﻩﺩﺎﻔﺘــﺳﺍ ﺎﺗ.ﺪﺷﺎﺑ ﻲﻣ ﺎﻜﻳﺮﻣﺍ ﺭﺩ ﺥﻮــﺴﻨﻣ ﻢﺘــﺴﻴﺳ ﻚﻳ ﺮﺿﺎﺣ ﻝﺎﺣ ﺭﺩ ﻭ ﺭﺩ ﻪﻧﺎﻴﻟﺎﺳ ﻲﻧﺎﺳﺭ ﺯﻭﺭ ﻪﺑ ﺪﻨﻳﺍﺮﻓ ﻢﺘــﺴﻴﺳ ﻦﻳﺍ ﺯﺍ ﻩﺩﺎﻔﺘــﺳﺍ ﻥﺎﻣﺯ ﻲﻧﺎﺳﺭ ﺯﻭﺭ ﻪﺑ ﺪﻨﻳﺍﺮﻓ ﻪﻛ ﻲﻟﺎﺣ ﺭﺩ ،ﺖــﺳﺍ ﻩﺪــﺷ ﻝﺎﻤﻋﺍ ﺎﻜﻳﺮﻣﺍ ﺮﻴﻴﻐﺗ ﻥﻭﺪﺑ ﻪﺨﺴﻧ ﺯﺍ ﻲﺘﺷﺍﺪﻬﺑ ﺰﻛﺍﺮﻣ ﻭ ﺩﻮﺷ ﻲﻤﻧ ﻩﺪﻳﺩ ﻥﺍﺮﻳﺍ ﺭﺩ ﻪﺨﺴﻧ ﺯﺍ ﻥﺍﺮﻳﺍ ﻩﺩﺎﻔﺘﺳﺍ ﻪﺑ ﻪﺟﻮﺗ ﺎﺑ.ﺪﻨﻨﻛ ﻲﻣ ﻩﺩﺎﻔﺘﺳﺍ ﻢﺘﺴﻴﺳ ﻦﻳﺍ ﻝﺎﻤﻋﺍ ﻥﺪﻧﺎﺠﻨﮔ ﻥﺎﻜﻣﺍ ،ﻢﺘــﺴﻴﺳ ﻲﻧﺎــﺳﺭ ﺯﻭﺭ ﻪﺑ ﻡﺪﻋ ﻭ ﻪﻴﻟﻭﺍ ﺪﻳﺪﺟ ﺕﺎﻣﺍﺪﻗﺍ .ﺪﺷﺎﺑ ﻲﻤﻧ ﺮــﺴﻴﻣ ﺪﻳﺪﺟ ﻲﺣﺍﺮﺟ ﻭ ﻲﻜــﺷﺰﭘ ﻢﺘﺴﻴﺳ ﻦﻳﺍ ﺭﺩ ﻕﻭﺮﻋ ﻭ ﺐﻠﻗ ﻱﺎﻫ ﻱﺭﺎﻤﻴﺑ ﻲﻜﺷﺰﭘ ﻭ ﻲﺣﺍﺮﺟ ﺕﺎﻣﺍﺪﻗﺍ ﻲﺒﺴﻧ ﺵﺯﺭﺍ ﺩﺭﻭﺁﺮﺑ ﻪﺠﻴﺘﻧ ﺭﺩ ﻭ ﺖﺳﺍ ﻩﺪﺸﻧ ﻒﻳﺮﻌﺗ .ﺪﺷﺎﺑ ﻲﻤﻧ ﺮﺴﻴﻣ ﺪﻳﺪﺟ ﻥﺎﻋﺫﺍ ﻥﺍﻮﺗ ﻲﻣ ﺶﻫﻭﮋﭘ ﺯﺍ ﻩﺪﻣﺁ ﺖﺳﺩ ﻪﺑ ﺞﻳﺎﺘﻧ ﻪﺑ ﻪﺟﻮﺗ ﺎﺑ ﻂﺒﺗﺮﻣ ﻲﺼﻴﺨﺸﺗ ﻱﺎﻫ ﻩﻭﺮﮔ ﻢﺘــﺴﻴﺳ ﻥﺩﺮﻛ ﻲﻣﻮﺑ ﻪﻛ ﺖــﺷﺍﺩ ﺭﺩ ^DRG ﺭﺎﺘﺧﺎــﺳ ﻪﺑ ﻪﺟﻮﺗ ﺎﺑ ﻕﻭﺮــﻋ ﻭ ﺐــﻠﻗ ﻱﺎــﻫ ﻱﺭﺎﻤﻴﺑ ﺖﻴﻤﻫﺍ ﺰﺋﺎﺣ ﺖﻣﻼــﺳ ﺕﺎﻋﻼﻃﺍ ﻡﺎﻈﻧ ءﺎﻘﺗﺭﺍ ﺖﻬﺟ ﺭﺩ ﻥﺍﺮﻳﺍ ﻩﺍﺭ ﻕﻭﺮﻋ ﻭ ﺐﻠﻗ ﻱﺎﻫ ﻱﺭﺎﻤﻴﺑ ﻲﻠﻣ ﻢﺘــﺴﻴﺳ ﺩﺎﺠﻳﺍ .ﺪــﺷﺎﺑ ﻲﻣ ﻭ ﻲﻧﺎﻣﺭﺩ ،ﻲﺘــﺷﺍﺪﻬﺑ ﻱﺎﻫﺯﺎﻴﻧ ﻪﺑ ﺦــﺳﺎﭘ ﻱﺍﺮﺑ ﻲﺒــﺳﺎﻨﻣ ﻞﺣ ﻦﻳﺍ ﻲﺣﺍﺮﻃ .ﺖﺳﺍ ﺭﻮــﺸﻛ ﺭﺩ ﻥﻼﻛ ﻱﺰﻳﺭ ﻪﻣﺎﻧﺮﺑ ﻭ ﻲــﺸﻫﻭﮋﭘ ﻪﺟﻮﺗ ﺎﺑ ﻭ ^DRG ﻢﺘﺴﻴﺳ ﻲﻠﺻﺍ ﺭﺎﺘﺧﺎﺳ ﻪﺑ ﻪﺟﻮﺗ ﺎﺑ ﺪﻳﺎﺑ ﻢﺘﺴﻴﺳ .ﺪﺷﺎﺑ ﻥﺍﺮﻳﺍ ﺭﺩ ﻲﺘــﺷﺍﺪﻬﺑ ﻱﺎﻫﺯﺎﻴﻧ ﻭ ﺎﻫ ﺖــﺳﺎﻴﺳ ،ﻑﺍﺪﻫﺍ ﻪﺑ

ﺐﺨﺘﻨﻣ ﻱﺎﻫﺭﻮﺸﻛ ﺭﺩ ﻕﻭﺮﻋ ﻭ ﺐﻠﻗ ﻱﺎﻫ ﻱﺭﺎﻤﻴﺑ ﻪﻨﻳﺰﻫ ﺩﺭﻭﺁﺮﺑ ﻢﺘﺴﻴﺳ ﻪﺴﻳﺎﻘﻣ :1 ﻝﻭﺪﺟ

ﺭﻮﺸﻛ ﻢﺘﺴﻴﺳ ﻡﺎﻧ

ﺕﺎﻴﺻﻮﺼﺧ ﺎﻫﺪﻛ ﺭﺎﺘﺧﺎﺳ

ﺎﻜﻳﺮﻣﺍ ﻲﻜﺷﺰﭘ ﻭ ﻲﺣﺍﺮﺟ ﺕﺎﻣﺍﺪﻗﺍ ﺶﺷﻮﭘ DRG

ﺩﺪﻋ ﻭ ﻑﺮﺣ ﺐﻴﻛﺮﺗ

ﺎﻴﻟﺍﺮﺘﺳﺍ AR-DRG,

(Australian Refined-DRG) MDC ﻩﺩﺭ 23 ﺎﺑ ﺐﺗﺍﺮﻣ ﻪﻠﺴﻠﺳ ﻱﺍﺭﺍﺩ

ﺩﺪﻋ ﻭ ﻑﺮﺣ ﺐﻴﻛﺮﺗ

ﺍﺩﺎﻧﺎﻛ CMG,

(Case Mix Groups) ﺺﻴﺨﺸﺗ ﻦﻳﺮﺘﺸﻴﺑ ﺭﺎﻴﻌﻣ ﺯﺍ ﻩﺩﺎﻔﺘﺳﺍ

ﻲﻨﻴﻟﺎﺑ ﻢﻬﻣ ﻱﺎﻫ ﻩﺩﺭ ﻭ ﻱﺭﺎﻤﻴﺑ ﺖﻴﻟﻮﺌﺴﻣ ﺩﺪﻋ ﻭ ﻑﺮﺣ ﺐﻴﻛﺮﺗ

ﺲﻴﻠﮕﻧﺍ HRG،

(Health Related Groups) ﻊﺒﻨﻣ ﺶﻳﺎﻤﻧ ﻭ ﻩﺪﺷ ﻪﺋﺍﺭﺍ ﺕﺎﻣﺪﺧ ﺶﺷﻮﭘ

ﺕﺎﻣﺪﺧ ﻪﺋﺍﺭﺍ ﺩﺪﻋ ﻭ ﻑﺮﺣ ﺐﻴﻛﺮﺗ

ﻥﺍﺮﻳﺍ -

- -

[15]ﻕﻭﺮﻋ ﻭ ﺐﻠﻗ DRG ﻱﺎﻫﺪﻛ ﻪﻧﻮﻤﻧ :2 ﻝﻭﺪﺟ

ﺪﻛ ﻒﻴﺻﻮﺗ

DRG ﺪﻛ

ﺮﻧﻭﺮﻛ ﺲﭘ ﻱﺎﺑ FO5A

ﺮﻧﻭﺮﻛ ﺲﭘ ﻱﺎﺑ ﺕﺎﻣﺍﺪﻗﺍ ﺮﻳﺎﺳ F07A

ﺐﻠﻗ ﺮﻜﻴﻣ ﺲﻴﭘ ﺖﺷﺎﻛ F12Z

ﭗﻤﭘ ﻥﻭﺪﺑ ﺐﻠﻗ ﻕﻭﺮﻋ ﻱﺯﺎﺳﺯﺎﺑ ﻡﺍﺪﻗﺍ F14A

ﺖﻨﺘﺳﺍ ﺎﺑ ﺮﻧﻭﺮﻛ ﻕﻭﺮﻋ ﻲﺘﺳﻼﭘﻮﻳﮋﻧﺁ F15Z

ﺖﻨﺘﺳﺍ ﻥﻭﺪﺑ ﺮﻧﻭﺮﻛ ﻕﻭﺮﻋ ﻲﺘﺳﻼﭘﻮﻳﮋﻧﺁ F16Z

ﺐﻠﻗ ﺮﻜﻴﻣ ﺲﻴﭘ ﺾﻳﻮﻌﺗ F17Z

ﻲﻧﻮﻔﻋ ﺖﻳﺩﺭﺎﻛﻭﺪﻧﺁ F61Z

ﻲﺒﻠﻗ ﻲﺋﺎﺳﺭﺎﻧ F62A

ﻥﺍﺮﻳﺍ -

(5)

(37) 12 ؛1388 ﺖﻣﻼﺳ ﺖﻳﺮﻳﺪﻣ

ﻱﺎﻫﺯﺎﻴﻧ ﺎﻬﻨﺗ ﻪﻧ ﻕﻭﺮﻋ ﻭ ﺐﻠﻗ ﻱﺎﻫ ﻱﺭﺎﻤﻴﺑ ^DRG ﻲﻠﻣ ﻢﺘﺴﻴﺳ ﻪﻨﻴﻣﺯ ﺭﺩ ﻩﺪــﺷ ﻪﺋﺍﺭﺍ ﺕﺎﻣﺪﺧ ﻱﺎﻫ ﻪﻨﻳﺰﻫ ﻪﺑ ﻁﻮﺑﺮﻣ ﻲﺗﺎﻋﻼﻃﺍ ﻂﺒﺗﺮﻣ ﺕﺎﻘﻴﻘﺤﺗ ﺭﺩ ﻪﻜﻠﺑ ﺪﻨﻛ ﻲﻣ ﻩﺩﺭﻭﺁﺮﺑ ﺍﺭ ﻥﺎﻣﺭﺩ ﻭ ﺖﺷﺍﺪﻬﺑ ﺰﻴﻧ ﻥﺎﻣﺭﺩ ﻭ ﺖــﺷﺍﺪﻬﺑ ﺰﻛﺍﺮﻣ ﻪﺟﺩﻮﺑ ﻭ ﻪﻨﻳﺰﻫ ﻱﺰﻳﺭ ﻪﻣﺎﻧﺮﺑ ﺎــﺑ .ﺩﻮﻤﻧ ﺪﻫﺍﻮﺧ ﺎﻔﻳﺍ ﻲﻤﻬﻣ ﺶﻘﻧ ﻭ ﻭﺮﺸﻴﭘ ﻱﺎﻫﺭﻮــﺸﻛ ﻪﻨﻳﺰﻫ ﺩﺭﻭﺁﺮﺑ ﻱﺎﻫ ﻢﺘــﺴﻴﺳ ﻪﻌﻟﺎﻄﻣ ﺪﻴﻔﻣ ﻭ ﺖﺒﺜﻣ ﻱﺪﻨﻳﺍﺮﻓ ﻥﺍﺮــﻳﺍ ﺭﺩ ﺩﻮﺟﻮﻣ ﻂﻳﺍﺮــﺷ ﺎﺑ ﻥﺁ ﻕﺎــﺒﻄﻧﺍ ﺭﺩ ﻱﺭﺎﺼﺤﻧﺍ ﻢﺘــﺴﻴﺳ ﻚﻳ ﻲﺣﺍﺮﻃ ﻊﻗﺍﻮﻣ ﻲﺧﺮﺑ ﺭﺩ .ﺪــﺷﺎﺑ ﻲﻣ ﻪﺑ ﻥﻭﺮﻘﻣ ﺖﻗﻭ ﻭ ﻲﻧﺎﺴﻧﺍ ﻭ ﻱﺩﺎﻣ ﻊﺑﺎﻨﻣ ، ﻪﻨﻳﺰﻫ ﻪﺑ ﻪﺟﻮﺗ ﺎﺑ ﺭﻮﺸﻛ ﻂﺒﺗﺮﻣ ﻲﺼﻴﺨﺸﺗ ﻱﺎﻫ ﻩﻭﺮﮔ ﻢﺘﺴﻴﺳ ﺯﺍ ﻩﺩﺎﻔﺘﺳﺍ .ﺖــﺴﻴﻧ ﻪﻓﺮﺻ ﻭ ﺎﻫﺯﺎﻴﻧ ﺎﺑ ﻂﺒﺗﺮﻣ ﺕﺎﺣﻼﺻﺍ ﻭ ﺕﺍﺮﻴﻴﻐﺗ ﺩﺎﺠﻳﺍ ﺎﺑ ﺎﻜــﻳﺮﻣﺍ ^DRG ﻪﺑ ﻝﻮﻘﻌﻣ ﺭﺎﻜﻫﺍﺭ ﻚﻳ ﻥﺍﻮﻨﻋ ﻪﺑ ﻥﺍﺮﻳﺍ ﺭﺩ ﺩﻮﺟﻮﻣ ﻲﺘﺷﺍﺪﻬﺑ ﻂﻳﺍﺮﺷ ﺎﻴﻟﺍﺮﺘﺳﺍ ،ﺲﻴﻠﮕﻧﺍ ﺪﻨﻧﺎﻣ ﻲﻳﺎﻫﺭﻮﺸﻛ ﺭﺩ ﻪﻛ ﻱﺪﻨﻳﺍﺮﻓ ،ﺪﺳﺭ ﻲﻣ ﺮﻈﻧ ﻪﺑ ﻁﻮﺑﺮﻣ ﺶﺨﺑ ﺭﺩ ﺩﻮﺷ ﻲﻣ ﺩﺎﻬﻨﺸﻴﭘ .ﺖﺳﺍ ﻩﺪﺷ ﻡﺎﺠﻧﺍ ﺍﺩﺎﻧﺎﻛ ﻭ ﺵﺯﻮﻣﺁ ﻭ ﻥﺎﻣﺭﺩ ،ﺖــﺷﺍﺪﻬﺑ ﺕﺭﺍﺯﻭ ﺏﻮﺼﻣ ﻪﻓﺮﻌﺗ ﺯﺍ ﻪــﻨﻳﺰﻫ ﻦﻳﺍ ﺭﺩ .ﺩﻮﺷ ﻩﺩﺎﻔﺘﺳﺍ ﺏﻮﺼﻣ ﻪﻓﺮﻌﺗ ﺎﻳ ﻝﺎﻳﺭ ﺱﺎﺳﺍ ﺮﺑ ﻲﻜــﺷﺰﭘ ﻢﺘﺴﻴﺳ ﻲﺣﺍﺮﻃ ﺭﺩ ﺪﻴﻔﻣ ﻱﺎﻫﺭﺎﻜﻫﺍﺭ ﻥﺍﻮﻨﻋ ﻪﺑ ﻞﻳﺫ ﺩﺭﺍﻮﻣ ﻪﻨﻴﻣﺯ :ﺩﻮﺷ ﻲﻣ ﺩﺎﻬﻨﺸﻴﭘ ﻥﺍﺮﻳﺍ ﻕﻭﺮﻋ ﻭ ﺐﻠﻗ ﻱﺎﻫ ﻱﺭﺎﻤﻴﺑ ^DRG ﻲﻠﻣ ،ﺖﺷﺍﺪﻬﺑ ﺕﺭﺍﺯﻭ ﺭﺩ ^DRG ﻢﺘﺴﻴﺳ ﻲﺼﺼﺨﺗ ﻪﺘﻴﻤﻛ ﺩﺎﺠﻳﺍ .1 .ﺮﻣﺍ ﻲﻟﻮﺘﻣ ﻥﺍﻮﻨﻋ ﻪﺑ ﻲﻜﺷﺰﭘ ﺵﺯﻮﻣﺁ ﻭ ﻥﺎﻣﺭﺩ ،ﻕﻭﺮﻋ ﻭ ﺐﻠﻗ ﻦﻴﺼﺼﺨﺘﻣ ﺖﻳﻮﻀﻋ ﺎﺑ ﻲﺗﺭﻮﺸﻣ ﻪﺘﻴﻤﻛ ﺩﺎﺠﻳﺍ .2 ﻲﻨﻴﻟﺎﺑ ﻥﺍﺭﺍﺬﮔﺪﻛ ،ﺎﻫ ﻱﺭﺎﻤﻴﺑ ﻱﺪﻨﺑ ﻪﻘﺒﻃ ﻱﺎﻫ ﻢﺘﺴﻴﺳ ﻦﻴﻟﻮﺌﺴﻣ ﻢﺘﺴﻴﺳ ﺮﺘﻬﺑ ﻲﺣﺍﺮﻃ ﺭﻮﻈﻨﻣ ﻪﺑ ﻲﻜــﺷﺰﭘ ﻡﻮﻠﻋ ﻱﺎﻫ ﻩﺎﮕــﺸﻧﺍﺩ ﻭ ﻑﺍﺪﻫﺍ ،ﺎﻫﺯﺎﻴﻧ ﺱﺎــﺳﺍ ﺮﺑ ﻕﻭﺮﻋ ﻭ ﺐﻠﻗ ﻱﺎﻫ ﻱﺭﺎﻤﻴﺑ ^DRG .ﻥﺍﺮﻳﺍ ﻲﺘﺷﺍﺪﻬﺑ ﻂﻳﺍﺮﺷ ﻥﺩﺮﻛ ﻲﻠﻣ ﻪﻨﻴﻣﺯ ﺭﺩ ﻭﺮﺸﻴﭘ ﻱﺎﻫﺭﻮﺸﻛ ﺕﺎﻴﺑﺮﺠﺗ ﺯﺍ ﻩﺩﺎﻔﺘﺳﺍ .3 .^DRG ﻢﺘﺴﻴﺳ ﻡﺎﻈﻧ ءﺎﻘﺗﺭﺍ ﺖﻬﺟ ﺭﺩ ﻱﺭﺍﺬﮔﺪﻛ ﻲﻠﻣ ﻱﺎﻫﺩﺭﺍﺪﻧﺎﺘﺳﺍ ﻪﻌﺳﻮﺗ .4 .ﻥﺍﺮﻳﺍ ﺭﺩ ﺖﻣﻼﺳ ﻢﺘــﺴﻴﺳ ﺎﺑ ﻭ ﻲﻣﻮﺑ ﻢﺘــﺴﻴﺳ ﻱﺎﻫ ﻩﺩﺍﺩ ﻦﻴﺑ ﻪــﺴﻳﺎﻘﻣ ﻲﻳﺎﻧﺍﻮﺗ .5 .ﺎﻫﺭﻮﺸﻛ ﺮﻳﺎﺳ ^DRG .ﺭﻮﺸﻛ ﻞﺧﺍﺩ ﺭﺩ ﻥﺪﺷ ﺪﻣﺁﺯﻭﺭ ﺖﻴﻠﺑﺎﻗ .6 .ﻢﺘﺴﻴﺳ ﻦﻳﺍ ﻱﺍﺮﺟﺍ ﺖﻬﺟ ﺭﺩ ﻥﺍﺭﺍﺬﮔﺪﻛ ﻪﺑ ﻡﺯﻻ ﺵﺯﻮﻣﺁ .7 ﻭ ﺐﻠﻗ ﻲﺼﺼﺨﺗ ﺰﻛﺮﻣ ﺪــﻨﭼ ﺭﺩ ﻢﺘــﺴﻴﺳ ﺕﻮﻠﻳﺎﭘ ﻱﺍﺮﺟﺍ .8 .ﻕﻭﺮﻋ

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Journal of Health Administration 2009; 12 (37)

Monajemi F.¹ / Safdari R.² / Ghorbani V.³

Abstract

Introduction: It is necessary for every country considers establishing such a system; considering to its goals, laws national, interests and standards. The main goal of this research was to compare the national cardiovascular disease DRG system in selected countries. This research is dealing with survey on system of Iran too.

Methods: This descriptive-comparative study conducted in 2007-2008. The cardiovascular diseases of DRG systems in USA, Australia, England and Canada were reviewed. Data collected through litera- ture review, Internet and e-mail, and presented in comparative tables.

Results: Our findings showed that all of the selected countries have national cardiovascular diseases of the DRG systems. This model employs health care standards, e-learning, annual educational pro- grams, and consultation with experts. Iran lacks such a national classification system for cardiovascular diseases.

Conclusion: Constituents of the model are: using a suitable committee for the cardiovascular DRG system in ministry of health and medical education, development coding standards, relationship between cardiologists and medical coders, presenting educational information about the national cardiovascular of the DRG system, using experiences of the developed countries.

Keywords:The Cardiovascular Diseases of DRG System, Cardiovascular Diseases, Coding, Selected Countries.

M.Sc. of Medical Records, Faculty Member of Education Vice Chancellor Ship, Ministry of Health and Medical Education Corresponding 1.

Author ([email protected])