离散度分析在门诊分级诊疗中的应用研究  

Application of Dispersion Analysis on Hierarchical Diagnosis and Treatment of Outpatient

作　　者：冯海欢[1] 崔欢欢 孙麟[1] Feng Haihuan;Cui Huanhuan;Sun Lin(Medical Insurance Office,West China Hospital of Sichuan University,Chengdu,610041)

机构地区：[1]四川大学华西医院医保办,成都610041

出　　处：《中国医疗保险》2020年第5期52-56,共5页China Health Insurance

基　　金：国家发改委“互联网+”、人工智能创新发展和数字经济试点重大工程“四川健康医疗大数据应用创新工程项目”子课题-医保大数据监控系统与DRGs研究(2018gfgw0001)。

摘　　要：目的:以C市某综合性三甲医院门特数据为例,筛选适合进行分级诊疗的门诊病种及人群。方法:结合门特病种的费用波动、人次代表性,应用离散度分析方法筛选重点病种,进一步定位维持性稳定治疗的下转人群范围。结果:该医院中类风湿关节炎和肿瘤病种具有代表性,费用波动明显,需要重点关注。类风关病种中48.02%的患者适合下转。结论:离散度分析可作为分级诊疗病种及人群筛选的工具之一,从医院管理的角度将分级诊疗的实施路径具体化。Objective: Taking the outpatient data of a general tertiary hospital as an example, the disease types and population suitable for hierarchical diagnosis and treatment were selected. Methods: Combined with the cost fluctuation of outpatient diseases and the number of visits, the dispersion analysis method was used to screen the key diseases and further locate the downward population range of stable treatment. Result: Rheumatoid arthritis and tumor disease in this hospital are both representative, and the cost fluctuation is obvious, which needs to be focused on. 48.02% of patients with rheumatoid arthritis were suitable forward down. Conclusion: Dispersion analysis can be used as one of the tools for disease and population screening of hierarchical diagnosis and treatment, and the implementation path of hierarchical diagnosis and treatment can be specified from the perspective of hospital management.

关 键 词：离散度分析 分级诊疗 医院管理 医保管理 

分 类 号：F840.684[经济管理—保险] C913.7[社会学]