基于DRGs的结直肠癌患者住院费用研究

Medical Expensed of Colorectal Cancer Patients Bases on Diagnosis Related Groups

[目的]探讨新疆地区结直肠癌患者住院费用标准的DRGs的病例组合方案。[方法]对2010年1月至2014年12月主要诊断为结直肠癌的有效病案2506份运用单因素分析、多因素分析、多元线性逐步回归及决策树模型中卡方自动互动检验法进行病例组合分类。[结果]结直肠癌患者住院费用均数44 445.70±30 048.16元,住院费用中位数为44 830.51元。住院天数、手术和化疗是结直肠癌患者住院费用的重要影响因素。结直肠癌患者病例组合方案的分类节点依次为住院天数、化疗、手术,分为7个诊断相关分组。[结论]以住院天数、化疗、手术为分类节点对结直肠癌患者住院费用进行分组是相对合理和可行的,对于制定医疗付费的标准、控制医疗费用不合理增长、避免过度医疗行为的发生有着重要的现实意义。

[Purpose] To estimate the medical expenses of colorectal cancer patients in Xinjiang province based on diagnostic related groups（DRGs）. [Methods] Total 2506 colorectal cancer patients admitted from January 2010 to December 2014 were collected from effective medical records.The patients were classified to subgroups by using univariate and multivariate regression analysis,multiple linear stepwise regression and decision tree models Chi-squared Automatic Interaction Detector methods. [Results] The mean medical expenses of colorectal cancer patients were 44 445.70±30 048.16 Yuan（median 44 830.51 Yuan）. The main influencing factors were days of hospital stay,operation and chemotherapy,which were the active factors to classify the inpatients into 7 different case mixes. [Conclusion] The medical expenses of patients with colorectal cancer are rational and feasible to be classified into seven case groups according to days of hospital stay,operation and chemotherapy,which will facilitate to control unreasonable increase of medical costs and to avoid the excessive medical treatment.