基于DRGs的阻塞性睡眠呼吸暂停综合征患者住院费用分析

Hospitalization Costs of Patients with Obstructive Sleep Apnea Syndrome Based on DRGs

目的探索阻塞性睡眠呼吸暂停综合征患者的住院费用影响因素及DRGs病例组分组方案,制定住院费用参考标准,为控制住院费用提供依据。方法选取2015年1月1日-2019年12月31日甘肃省某三甲综合医院首次确诊的640例阻塞性睡眠呼吸暂停综合征患者为研究对象,采用单因素分析和逐步回归法对病例数据进行分析,筛选分类节点变量再利用决策树模型建立DRGs病例组合模型。结果住院天数、是否手术、身体质量指数作为阻塞性睡眠呼吸暂停综合征的分类节点变量进入了决策树模型,共产生9个DRGs分组及相应的住院标准费用,经预测最高标准费用为24238.93元,最低标准费用为7005.17元。结论阻塞性睡眠呼吸暂停综合征病例分组合理,通过制定不同病例组的住院费用标准,缩短住院天数及完善医保制度,有效控制住院费用增长。同时完善住院病案首页数据质量,为DRGs付费的推行打下坚实的基础。

Objectives To explore the influencing factors of the hospitalization cost of patients with obstructive sleep apnea syndrome and the case combination and grouping scheme of DRGs, so as to establish the reference standard of the hospitalization cost, and to provide the basis for the control of the hospitalization cost. Methods From January 1 st, 2015 to December 31 st, 2019, 640 patients with obstructive sleep apnea syndrome diagnosed for the first time in a Three A and Tertiary General hospital in Gansu Province were selected as the research objects. Single factor analysis and stepwise regression method were used to analyze the case data, and classification node variables were screened to establish a DRGs case combination model using decision tree model. Results The number of days in hospital, whether surgery was performed or not, and body mass index were used as the classification node variables of obstructive sleep apnea syndrome into the decision tree model. A total of 9 combinations of DRGs were generated and the corresponding standard cost of hospitalization was predicted. The highest standard cost was 24 238.93 yuan, and the lowest standard cost was 7005.17 yuan. Conclusions Obstructive sleep apnea syndrome cases were grouped reasonably, and the increase of hospitalization cost was effectively controlled by establishing hospitalization cost standards for different patient groups, shortening hospitalization days and improving medical insurance system. At the same time, improve the data quality of the front page of medical records, and lay a solid foundation for the implementation of DRGs payment.