基于决策树模型脑卒中患者住院费用DRG分组实证研究  

Empirical Study on the DRGs in Patients with Cerebral Apoplexy Based on Decision Tree Model

作　　者：高峰[1] 郑二维[1] 张清芝[1] 腾慧杰 GAO Feng;ZHENG Er-wei;ZHANG Qing-zhi(The First Hospital of Harbin Medical University,Harbin,150001,China)

机构地区：[1]哈尔滨医科大学附属第一医院,哈尔滨150001

出　　处：《中国卫生经济》2020年第4期33-35,共3页Chinese Health Economics

基　　金：黑龙江省卫生计生委科研课题(2017-043)。

摘　　要：目的:通过对哈尔滨医科大学附属第一医院脑卒中患者进行DRG分组,制定脑卒中患者住院费用的参考标准。方法:获得样本医院2018年主要诊断为脑卒中患者病案首页信息及患者费用资料21391例,采用多重逐步回归法确定住院费用的主要影响因素并作为分类指标,利用数据挖掘工具中的决策树模型E-CHAID法建立脑卒中DRG病例组合方案及费用标准。结果:住院天数、是否手术、有无并发症或合并症作为影响脑卒中病例住院费用的分类节点,建立了8个DRG组合和收费标准。结论:采用决策树模型CHAID法进行DRG分组科学合理,以DRG分组结果制定住院费用标准有利于合理配置医疗资源、提高医疗质量与效率,对规范医疗行为及控制医疗资源不合理消耗具有重要的实际意义,为本地区DRG的开展及推进提供参考。Objective:Through the DRG grouping of cerebral apoplexy patients in the First Affiliated Hospital of Harbin Medical University,the reference standard of hospitalization expenses for cerebral apoplexy patients is established.Methods:Samples of 21391 patients with stroke diagnosed in the sample hospital in 2018 were obtained.The main influencing factors of hospitalization costs are determined by multiple stepwise regression method and classified as indicators.The decision tree model E-CHAID method in data mining tool is used to establish DRG case combination scheme and the cost standard for stroke patients.Results:The number of days in hospital,whether taking the operation or complications are used as the classification nodes to influence the hospitalization expenses of cerebral apoplexy patients.8 DRG combinations and charging standards are established.Conclusion:The decision tree model chaid method is used to grouping DRG scientifically and reasonably.It has great practical significance to standardize medical behavior and control unreasonable consumption of medical resources by formulating hospitalization cost standard with DRG grouping results,which is beneficial to the rational allocation of medical resources,improves the quality and efficiency of medical treatment.It has great practical significance to standardize medical behavior and control the unreasonable consumption of medical resources,which provides a reference for the development and promotion of DRG in this area.

关 键 词：按疾病诊断相关分组 脑卒中 住院费用 决策树模型 

分 类 号：R1-9[医药卫生—公共卫生与预防医学] F840.613[经济管理—保险]