宫颈癌患者住院费用的DRGs分组研究

Case mixed method in a DRGs-based study of the hospitalization expenses of patients with cervical cancer

目的研究南通地区宫颈癌的DRGs病例组合方案，制定宫颈癌患者住院费用的参考标准。方法以南通市肿瘤医院2006年至2013年诊断为宫颈癌的8610例患者为研究对象，利用多元线性回归提取住院费用的影响因素，采用决策树模型中卡方自动互动检验法，建立宫颈癌患者的DRGs病例组合方案。结果宫颈癌患者住院费用均数为11363元，中位数为9325元。住院费用的影响因素包括入院途径、并发症、治疗方法及转归。8610例宫颈癌病例共形成11个DRGs组合及相应的住院费用标准。结论宫颈癌病例分组合理，住院费用标准及病种权重可为医院和医疗保险机构决策提供参考。

Objective To explore the case mixed method in diagnosis-related groups （DRGs） of patients with cervical cancer in Nantong and to provide references for standard hospitalization expense of cervical cancer. Methods 8 610 patients with cervical cancer from Nantong Tumor Hospital from 2006 to 2013 were selected for the study. The influencing factors of hospitalization expenses were screened by multiple liner regression. DRGs case mix scheme was established by Chi-squared automatic interaction dtector in the decision tree model. Results The mean hospitalization expense was 11 363 yuan and the median was 9 325 yuan. The influencing factors included admitting pathways, complications, therapeutic methods and prognosis of diseases. The cases of 8 610 formed 11 DRGs combinations, with the corresponding hospitalization expense standards. Conclusions Case-mix diagnosis related groups are reasonable. The standards and related weights of hospitalization expenses could serve references for hospitals and medical insurance institutions.