基于DRGs的胆囊结石伴急性胆囊炎单病种费用研究

Hospitalization Expenses Analysis on Patients With of Single Disease Payment Basing on DRGs: A Case Study of Acute Calculous Cholecystitis

目的制定胆囊结石伴急性胆囊炎患者的病例组合方案及费用标准。方法提取某院2016年1月—2018年12月的771例胆囊结石伴急性胆囊炎出院患者病案首页资料,采用Logistic回归分析筛选分类节点变量,运用决策树模型进行病例组合分组,计算各组的费用标准。结果胆囊结石伴急性胆囊炎住院费用的主要影响因素有:年龄、手术方式、住院天数、并发症;通过对771例胆囊结石伴急性胆囊炎患者分组,共形成5个DRGs组合和相对应住院费用标准。结论通过应用以治疗方式及手术方式为主要分类节点的DRGs分组方式,制定符合胆囊结石伴急性胆囊炎患者住院费用标准可为医疗费用支付方式改革提供参考。

Objective To investigate the combination of DRGs cases of acute calculous cholecystitis. Methods From January 2016 to December 2018,771 discharged patients with cholecystolithiasis and acute cholecystitis in a hospital were collected.Logistic regression analysis was uesd to screen the variables of classification nodes.Decision tree model was used to group cases and calculate the cost standard of each group. Results The main influencing factors of hospitalization expenses of gallstone patients with acute cholecystitis are age, operation mode, hospitalization days and complications. By grouping 771 cases of gallstone patients with acute cholecystitis, five DRGs combinations and corresponding hospitalization expenses standards were formed. Conclusion By using DRGs grouping method with treatment and operation as the main classification nodes, the hospital expenses standard for patients with gallstone and acute cholecystitis can be formulated, which can provide reference for the reform of medical expenses payment mode.