Study on the DRGs sub-grouping of patients with HC25 disease group and the influencing factors of hospitalization expenses based on decision tree model
Objective To study the DRGs grouping of patients with HC25 disease and the influencing factors of hospitalization ex-penses based on decision tree model.Methods From January 2020 to June 2022,collected the first page data of medical records of patients who were admitted to the HC25(cholecystectomy,without complications or complications)group were collected according to the CHS-DRG grouping scheme in a tertiary hospital in the First Affiliated Hospital of Xi'an Jiaotong University(n=3 844).The main factors affecting hospital-ization costs were analyzed through univariate and multivariate analysis,and the cases were combined by establishing a decision tree model to analyze the grouping effect and cost standards.Results The results of normality test showed that the hospitalization expenses were skewed(χ2 =0.197,P<0.001).Univariate analysis showed that there were significant differences among patients in different ages,genders,surgical meth-ods,patient sources,medical payment methods,severity of admission,preoperative time,length of stay,and whether there was a re-hospitalization plan(P<0.05).The results of multiple linear stepwise regression analysis showed that the factors influencing the significant dif-ference of hospitalization expenses from large to small were:length of stay,mode of operation,severity of hospitalization,gender,preoperative time,source of patients,and re-hospitalization plan(P<0.05).A total of 7 DRGs were generated using CHAID,on the first level,the classifica-tion node variable was the operation mode,the second level is the preoperative time and hospital stay,and the third level is the critical condi-tion at admission.The hospitalization expenses of different DRGs combinations were statistically different(χ2=2 474.595,P<0.001).The hospi-talization expenses and weight of DRGs combination(1)were the highest;DRGs(7)had the lowest hospitalization cost and weight;there were 170 patients(4.42%)in all DRGs disease groups with excessive expenses,and the proportion of excessive expenses in each group was less than 10%.Conclusions Based on the CHAID,the sub-grouping effect of HC25 is reasonable and effective,which can objectively reflect the level of medical resource consumption.
CholecystectomyDecision treeDisease diagnosis related groupingHospitalization expenses
NETL
NSTL
万方数据
维普
