脑血管病诊断相关组分组及质控研究  

Study on DRGs grouping and quality control of cerebrovascular disease

作　　者：汪春晖[1] 胡佳乐[1] 刘玉秀[1] 杜德洁[1] 

机构地区：[1]南京军区南京总医院医务部,南京医学硕士210002

出　　处：《医学研究生学报》2015年第10期1079-1082,共4页Journal of Medical Postgraduates

基　　金：江苏省医学人文社会科学基金(JSYRKJ2014-B1-06)

摘　　要：目的诊断相关组(diagnosis related groups,DRGs)是一种按资源消耗分类的病例组合方案,对医疗费用增长的控制有显著效果。文中探讨适合南京地区三级甲等医院脑血管病DRGs病例分组方案及质控指标方案。方法采用多分类有序反应变量logistic回归分析住院费用影响因素,E-CHAID决策树法对脑血管病例进行DRGs分组。结果共纳入9095例合格病例,平均年龄(64.52±14.85)岁,平均住院天数(11.77±9.26)d,平均住院总费用(25 921.04±23 096.76)元。神经系统手术、主要诊断、介入手术、主要合并症、ICU天数与住院费用相关,以神经系统手术为强制使用第一个变量,共分为14个DRGs组。结论采用脑血管病诊断相关组分组方法制定的脑血管病DRGs终末质控指标、环节警示指标和个例上限指标适合南京地区。Objective Diagnosis related groups（ DRGs） is a system to classify hospital cases into groups,which is effective in the control of medical cost. The article was to explore the DRGs grouping method and quality control indexes of cerebrovascular disease in Nanjing first-class hospitals at grade 3. Methods Polytomous logistic regression for ordinal response was used in the factor analysis of hospitalization cost. E-CHAID decision tree method was applied in the DRGs grouping of cerebrovascular patients.Results Totally 9095 cases were enrolled in this study with the average age was（ 64. 52 ± 14. 85）. The average of stay lengths and expenses were（ 11. 77 ± 9. 26） d and（ 25 921. 04 ± 23 096. 76） rmb respectively. Hospitalization expense was associated with neurological surgery,main diagnosis,interventional surgery,main complication and ICU days. Taking neurological surgery as the first forced variable,cerebrovascular cases could be divided into 14 DRGs groups. Conclusion The terminal quality control index,the step warning index and case maximum index of cerebrovascular disease established by the DRGs grouping method are suitable in the area.

关 键 词：脑血管病 诊断相关组 质控指标 

分 类 号：R743[医药卫生—神经病学与精神病学]