基于通径分析和决策树模型的异位妊娠手术患者病例组合研究  

Case-Mix Study of Surgery Patients with Ectopic Pregnancy Based on Path Analysis and Decision Tree Model

作　　者：彭伟彬[1,2] 刘颜 鲍俊翠[3] 梅婧[2] 林华照[4] 冯笑玲[5] PENG Wei-bin;LIU Yan;BAO Jun-cui

机构地区：[1]广州医科大学,广州510000 [2]北京大学深圳医院病案统计室,广东深圳518036 [3]北京大学深圳医院妇产科,广东深圳518036 [4]广东省妇幼保健院科教科,广州518036 [5]深圳市第三人民医院精案室,广东深圳510000

出　　处：《中国卫生经济》2018年第12期91-93,共3页Chinese Health Economics

基　　金：深圳市科技研发资金项目(JCYJ20150403091443299).

摘　　要：目的:探索异位妊娠手术患者的病例组合方案及费用标准,为相关部门决策提供参考依据。方法:提取深圳市某三级甲等医院2013—2016年1 470例异位妊娠手术患者病历资料,采用通径分析筛选分类结点变量,运用决策树模型进行病例分组,计算各组合标准费用、警示费用、费用上限等指标。结果:异位妊娠手术患者病例组合的分类节点包括治疗方式、伴随病、病例分型、输血、抢救、并发症,共形成6个DRG组,各DRG组的组间异质性和组内同质性良好。结论:制定科学合理的病例组合及费用标准有利于控制医疗费用不合理上涨。Objective: To explore the case-mix diagnosis-related-groups and cost criteria for surgery patients with ectopic pregnancy and provide references for the decision-making of relevant departments. Methods: The medical records of 1 470 surgery patients with ectopic pregnancy in a tertiary hospital of Shenzhen from 2013 to 2016 were extracted. Path analysis and decision tree model were used to screen the classification node variables, set up the case-mix diagnosis-related-groups and calculate the standard costs, warning fees, cost cap and other indicators for each group. Results: The classification node variables of the surgery patients with ectopic pregnancy included therapies, concomitant diseases, case type, blood transfusion, rescue and complications. A total of 6 DRG groups were formed, and the heterogeneity and homogeneity of each group were well. Conclusion: The establishment of scientific and reasonable case-mix diagnosis-related-groups and cost criteria were conducive to control the irrational increase of medical expenses.

关 键 词：异位妊娠 病例组合 决策树模型 

分 类 号：R1-9[医药卫生—公共卫生与预防医学] F224.9[经济管理—国民经济]