合并多种慢性病的缺血性心脏病患者住院费决策树分析  

Decision tree analysis of hospitalization expenses for ischemic heart disease patients with multiple chronic diseases

作　　者：毛英 孙李丽 刘芳[1] 杨淑梅[1] 郭玲利 王磊 Mao Ying;Sun Lili;Liu Fang;Yang Shumei;Guo Lingli;Wang Lei(Department of Medical Record Statistics,The Fifth Hospital of Xinjiang Medical University,Urumqi 830011,China;Department of educational administration,Xinjiang Medical University,Urumqi 830011,China)

机构地区：[1]新疆医科大学第五附属医院医务部,新疆乌鲁木齐830011 [2]新疆医科大学教务处,新疆乌鲁木齐830011

出　　处：《中国医院统计》2023年第5期381-386,共6页Chinese Journal of Hospital Statistics

基　　金：省部共建中亚高发病成因与防治国家重点实验室-新疆医科大学第五附属医院联合项目(SKL-HIDCA-2021-WF1)。

摘　　要：目的 分析新疆维吾尔自治区某医院合并多种慢性病的缺血性心脏病患者住院费的影响因素,预测缺血性心脏病患者住院费及差异关键点。方法 采用决策树E-CHAID方法分析新疆维吾尔自治区某医院合并多种慢性病缺血性心脏病患者住院费数据、对数据进行最优分割,建立病例组合模型,通过剪枝控制决策树的结构和规模,预测合并多种慢性病的缺血性心脏患者影响因素、最优组合路径及住院费。结果 影响患者住院费的5个关键因素为治疗方式、实际住院天数、合并症个数、疾病类型和是否有慢性肾病;通过决策树模型形成了14个最优组合路径。结论 决策树模型能分析影响住院费的关键因素,帮助卫生管理部门找到最优分组路径,为后续优化临床路径、医保支付改革提供思路和助力。Objective To analyze the influencing factors of hospitalization expenses for ischemic heart disease patients with multiple chronic diseases in Xinjiang,and to predict the hospitalization expenses in patients with ischemic heart disease and the key differences.Methods The E-CHAID method was used to analyze the influencing factor data of hospitalization expenses for patients with multiple chronic ischemic heart diseases in Xinjiang,and the data were performed optimal segmentation to establish a case combination model.The structure and scale of the decision tree were controlled by pruning to predict the influencing factors,optimal combination path,and hospitalization expenses of ischemic heart patients with multiple chronic diseases.Results The 5 factors were treatment method,actual length of hospital stay,number of complications,the type of diseases,and chronic kidney disease or not.Through the decision tree model,14 optimal combination paths are formed.Conclusion The decision tree model can be used to analyze the key factors affecting hospitalization expenses,but also help the health management departments to find the optimal grouping path,so as to provide ideas and assistance for optimizing clinical pathways and reforming medical insurance payments in the future.

关 键 词：缺血性心脏病 住院费 价值导向 E-CHAID 

分 类 号：R197.32[医药卫生—卫生事业管理]