剖宫产住院费用的影响因素及病例组合管理模式分析

Analysis of Influence Factors and Case Combination about Hospitalization Expenses of Cesarean Delivery

目的探讨剖宫产产妇住院费用的影响因素及不同病例组合下的费用控制。方法对2000年1月至2017年12月广州市某三甲医院剖宫产手术的8080例产妇病案首页数据进行Logistic、决策树和病例组合分析。结果根据Logistic回归分析和决策树分析结果,用住院天数、药占比、妊娠合并疾病、患者来源和参保情况共5个变量进行剖宫产住院费用的预测,预测准确率为70.58%。形成8种病例组合情况,筛选出超额费用患者483例,占5.98%。结论合理控制住院天数、合理用药监管及参保管理是降低剖宫产住院费用的可行措施;病例组合方法对于剖宫产产妇住院费用的管理和控制有积极的意义。

Objective To discuss influence factors of hospitalization expenses of cesarean delivery and cost control under different case combinations.Methods Medical records of cesarean delivery women from a tertiary hospital during Jan 2000 and Dec 2017 in Guangzhou city were analyzed using logistic regression,decision tree and case combination analysis.Results According to the Results of Logistic analysis and decision tree analysis,hospitalization days,drug proportion,pregnancy complicated with disease,places coming from and insurance were used to do the prediction of hospital expenses of cesarean delivery with predict accuracy 70.58%.8 case combinations were formed,screened out the excess charges in 483 cases,accounted for 5.98%.Conclusion Appropriate of reducing hospitalization days,supervising drug-use and insurance management are feasible measures for reducing hospitalization expenses of cesarean delivery women.Case combination method has positive influences for hospitalization expenses control of cesarean delivery women.