基于决策树模型的不同放疗方式对住院费用影响因素分析  

Analyze on the Influence of Different Radiotherapy Methods on Hospitalization Costs with the Application of Regression Tree Model

作　　者：王锦毓 袁波英 杨永挺 Wang Jinyu;Yuan Boying;Yang Yongting(Cancer Hospital Affiliated to the University of Chinese Academy of Sciences,Hangzhou 310000,Zhejiang Province,China;不详)

机构地区：[1]中国科学院大学附属肿瘤医院,浙江省杭州市310000

出　　处：《中国病案》2022年第3期50-53,共4页Chinese Medical Record

基　　金：浙江省医院可持续发展正大天晴研究项目(2019ZHA-ZDTQ206)。

摘　　要：目的 通过构建回归决策树模型探讨影响放疗患者住院费用的影响因素,为疾病诊断相关分组提供依据。方法 选取某省级三甲肿瘤专科医院2019年1月1日-2019年6月30日出院主要诊断为Z51.0或Z51.8放射治疗相关编码的患者共3630例,比较不同年龄、治疗操作、并发症/合并症及放疗方式患者的费用情况,并构建回归决策树模型。结果 纳入分析的患者3235例,最终模型分组:住院费用螺旋断层放射治疗(123796.33元)、调强放射治疗伴有并发症或伴随症(51698.21元)、调强放射治疗不伴有并发症或伴随症(37 547.84元)、同位素治疗伴并发症或伴随症(17 407.35元)、同位素治疗不伴并发症或伴随症且年龄≥60岁(16828.62元)、同位素治疗不伴并发症伴随症且年龄<60岁(15086.55元)和后装腔内放射治疗(8549.44元)。结论 除年龄、伴随的并发症之外,放疗方式可能是放疗患者住院费用的一个重要影响因素,疾病诊断相关分组器需综合考虑放疗方式的影响。Objectives To explore the factors influencing the cost of inpatients who accepted radiotherapy based on regression tree model,so as to provide evidence for the Diagnosis Related Groups(DRGs).Methods From January 1st,2019 to June 30th,2019,medical records of patients with radiotherapy related discharge diagnosis on ICD-10coding in a Three A and Tertiary Hospital were collected.Age,treatment operations,complications and radiotherapy techniques were included as independent variables to compare patients’ hospitalization expenses and construct the regression tree model.Results A total of 3235 patients were included in the analysis,and the final model grouping was as follows:spiral tomography radiotherapy(123 796.33 yuan),intensity modulated radiotherapy with complications or concomitant diseases(51 698.21 yuan),intensity modulated radiotherapy without complications or concomitant diseases(37 547.84 yuan),isotope therapy with complications or concomitant diseases(17 407.35 yuan),isotope therapy without complications or concomitant diseases and age ≥6 0 years old(16 828.62 yuan),isotope therapy without complications and with age <60 years old(15 086.55 yuan),and post-loading endovascular radiation therapy(8549.44 yuan).Conclusion Besides complications and age of patients,radiotherapy techniques could affect hospitalization expenses,thence the Diagnosis Related Groups for medical insurance payment should take these factors into consideration.

关 键 词：回归决策树 疾病诊断相关分组 放疗方式 

分 类 号：R197.3[医药卫生—卫生事业管理]