BACKGROUND Breast cancer is one of the most common malignant tumors in women worldwide and poses a severe threat to their health.Therefore,this study examined patients who underwent breast cancer surgery,analyzed hosp...BACKGROUND Breast cancer is one of the most common malignant tumors in women worldwide and poses a severe threat to their health.Therefore,this study examined patients who underwent breast cancer surgery,analyzed hospitalization costs and structure,and explored the impact of China Healthcare Security Diagnosis Related Groups(CHS-DRG)management on patient costs.It aimed to provide medical institutions with ways to reduce costs,optimize cost structures,reduce patient burden,and improve service efficiency.AIM To study the CHS-DRG payment system’s impact on breast cancer surgery costs.METHODS Using the CHS-DRG(version 1.1)grouping criteria,4073 patients,who underwent the radical resection of breast malignant tumors from January to December 2023,were included in the JA29 group;1028 patients were part of the CHS-DRG payment system,unlike the rest.Through an independent sample t-test,the length of hospital stay as well as total hospitalization,medicine and consumables,medical,nursing,medical technology,and management expenses were compared.Pearson’s correlation coefficient was used to test the cost correlation.RESULTS In terms of hospitalization expenses,patients in the CHS-DRG payment group had lower medical,nursing,and management expenses than those in the diagnosis-related group(DRG)non-payment group.For patients in the DRG payment group,the factors affecting the total hospitalization cost,in descending order of relevance,were medicine and consumable costs,consumable costs,medicine costs,medical costs,medical technology costs,management costs,nursing costs,and length of hospital stay.For patients in the DRG nonpayment group,the factors affecting the total hospitalization expenses in descending order of relevance were medicines and consumable expenses,consumable expenses,medical technology expenses,the cost of medicines,medical expenses,nursing expenses,length of hospital stay,and management expenses.CONCLUSION The CHS-DRG system can help control and reduce unnecessary medical expenses by controlling medicine costs,medical consumable costs,and the length of hospital stay while ensuring medical safety.展开更多
AIM： To figure out the contributed factors of the hospitalization expenses of senile cataract patients（HECP） and build up an area-specified senile cataract diagnosis related group（DRG） of Shanghai thereby formula...AIM： To figure out the contributed factors of the hospitalization expenses of senile cataract patients（HECP） and build up an area-specified senile cataract diagnosis related group（DRG） of Shanghai thereby formulating the reference range of HECP and providing scientific basis for the fair use and supervision of the health care insurance fund.METHODS： The data was collected from the first page of the medical records of 22 097 hospitalized patients from tertiary hospitals in Shanghai from 2010 to 2012 whose major diagnosis were senile cataract. Firstly, we analyzed the influence factors of HECP using univariate and multivariate analysis. DRG grouping was conducted according to the exhaustive Chi-squared automatic interaction detector（E-CHAID） model, using HECP as target variable. Finally we evaluated the grouping results using non-parametric test such as Kruskal-Wallis H test, RIV, CV, etc.RESULTS： The 6 DRGs were established as well as criterion of HECP, using age, sex, type of surgery and whether complications/comorbidities occurred as the key variables of classification node of senile cataract cases.CONCLUSION： The grouping of senile cataract cases based on E-CHAID algorithm is reasonable. And the criterion of HECP based on DRG can provide a feasible way of management in the fair use and supervision of medical insurance fund.展开更多
Utilising dissolved gases analysis, a new insulation fault diagnosis methodfor power transformers is proposed. This method is based on the group grey relational grade analysismethod. First, according to the fault type...Utilising dissolved gases analysis, a new insulation fault diagnosis methodfor power transformers is proposed. This method is based on the group grey relational grade analysismethod. First, according to the fault type and grey reference sequence structure, some typicalfault samples are divided into several sets of grey reference sequences. These sets are structuredas one grey reference sequence group. Secondly, according to a new calculation method of the greyrelational coefficient, the individual relational coefficient and grade are computed. Then accordingto the given calculation method for the group grey relation grade, the group grey relational gradeis computed and the group grey relational grade matrix is structured. Finally, according to therelational sequence, the insulation fault is identified for power transformers. The results of alarge quantity of instant analyses show that the proposed method has higher diagnosis accuracy andreliability than the three-ratio method and the traditional grey relational method. It has goodclassified diagnosis ability and reliability.展开更多
Objective To implement the national diagnosis related group(DRG)policy smoothly,and gradually move towards value medicine and fine management,some suggestions are put forward for improving medical service efficiency,s...Objective To implement the national diagnosis related group(DRG)policy smoothly,and gradually move towards value medicine and fine management,some suggestions are put forward for improving medical service efficiency,saving medical insurance fund,and reducing the burden of patients,so as to realize the win-win situation of medical insurance and patients.Methods Based on the experience of the United States,Australia,and Germany,the policy implementation background and development process in China were summarized.The advantages and disadvantages of single disease payment method,disease score payment method,and diagnosis related groups-prospective payment system(DRG-PPS)method were compared,and then the problems were found out.Results and Conclusion In view of the imperfect information system,lack of professional talents,and uneven progress of each pilot,it is proposed that relevant departments should pay more attention to the construction and improvement of coding and other information systems,cultivate professional talents,promote the reform of DRG payment technology specification and grouping technology combined with national pilot project,thus enhancing the application and in-depth development of DRG policy in China.展开更多
基金Research Center for Capital Health Management and Policy,No.2024JD09.
文摘BACKGROUND Breast cancer is one of the most common malignant tumors in women worldwide and poses a severe threat to their health.Therefore,this study examined patients who underwent breast cancer surgery,analyzed hospitalization costs and structure,and explored the impact of China Healthcare Security Diagnosis Related Groups(CHS-DRG)management on patient costs.It aimed to provide medical institutions with ways to reduce costs,optimize cost structures,reduce patient burden,and improve service efficiency.AIM To study the CHS-DRG payment system’s impact on breast cancer surgery costs.METHODS Using the CHS-DRG(version 1.1)grouping criteria,4073 patients,who underwent the radical resection of breast malignant tumors from January to December 2023,were included in the JA29 group;1028 patients were part of the CHS-DRG payment system,unlike the rest.Through an independent sample t-test,the length of hospital stay as well as total hospitalization,medicine and consumables,medical,nursing,medical technology,and management expenses were compared.Pearson’s correlation coefficient was used to test the cost correlation.RESULTS In terms of hospitalization expenses,patients in the CHS-DRG payment group had lower medical,nursing,and management expenses than those in the diagnosis-related group(DRG)non-payment group.For patients in the DRG payment group,the factors affecting the total hospitalization cost,in descending order of relevance,were medicine and consumable costs,consumable costs,medicine costs,medical costs,medical technology costs,management costs,nursing costs,and length of hospital stay.For patients in the DRG nonpayment group,the factors affecting the total hospitalization expenses in descending order of relevance were medicines and consumable expenses,consumable expenses,medical technology expenses,the cost of medicines,medical expenses,nursing expenses,length of hospital stay,and management expenses.CONCLUSION The CHS-DRG system can help control and reduce unnecessary medical expenses by controlling medicine costs,medical consumable costs,and the length of hospital stay while ensuring medical safety.
基金Supported by the Key Research and Development Program of Hunan Province(No.2017SK2011)
文摘AIM： To figure out the contributed factors of the hospitalization expenses of senile cataract patients（HECP） and build up an area-specified senile cataract diagnosis related group（DRG） of Shanghai thereby formulating the reference range of HECP and providing scientific basis for the fair use and supervision of the health care insurance fund.METHODS： The data was collected from the first page of the medical records of 22 097 hospitalized patients from tertiary hospitals in Shanghai from 2010 to 2012 whose major diagnosis were senile cataract. Firstly, we analyzed the influence factors of HECP using univariate and multivariate analysis. DRG grouping was conducted according to the exhaustive Chi-squared automatic interaction detector（E-CHAID） model, using HECP as target variable. Finally we evaluated the grouping results using non-parametric test such as Kruskal-Wallis H test, RIV, CV, etc.RESULTS： The 6 DRGs were established as well as criterion of HECP, using age, sex, type of surgery and whether complications/comorbidities occurred as the key variables of classification node of senile cataract cases.CONCLUSION： The grouping of senile cataract cases based on E-CHAID algorithm is reasonable. And the criterion of HECP based on DRG can provide a feasible way of management in the fair use and supervision of medical insurance fund.
文摘Utilising dissolved gases analysis, a new insulation fault diagnosis methodfor power transformers is proposed. This method is based on the group grey relational grade analysismethod. First, according to the fault type and grey reference sequence structure, some typicalfault samples are divided into several sets of grey reference sequences. These sets are structuredas one grey reference sequence group. Secondly, according to a new calculation method of the greyrelational coefficient, the individual relational coefficient and grade are computed. Then accordingto the given calculation method for the group grey relation grade, the group grey relational gradeis computed and the group grey relational grade matrix is structured. Finally, according to therelational sequence, the insulation fault is identified for power transformers. The results of alarge quantity of instant analyses show that the proposed method has higher diagnosis accuracy andreliability than the three-ratio method and the traditional grey relational method. It has goodclassified diagnosis ability and reliability.
基金General Projects of Social Science Planning Fund of Liaoning Province(L19BGL034)Shenyang Philosophy and Social Science Planning Fund Project(SZ202001L)Key Projects of Shenyang Social Science Fund(SYSK2020-04-01).
文摘Objective To implement the national diagnosis related group(DRG)policy smoothly,and gradually move towards value medicine and fine management,some suggestions are put forward for improving medical service efficiency,saving medical insurance fund,and reducing the burden of patients,so as to realize the win-win situation of medical insurance and patients.Methods Based on the experience of the United States,Australia,and Germany,the policy implementation background and development process in China were summarized.The advantages and disadvantages of single disease payment method,disease score payment method,and diagnosis related groups-prospective payment system(DRG-PPS)method were compared,and then the problems were found out.Results and Conclusion In view of the imperfect information system,lack of professional talents,and uneven progress of each pilot,it is proposed that relevant departments should pay more attention to the construction and improvement of coding and other information systems,cultivate professional talents,promote the reform of DRG payment technology specification and grouping technology combined with national pilot project,thus enhancing the application and in-depth development of DRG policy in China.
