Study On Integration Mode And Methods Of Health Care Service Cost Management For DRG

The dissertation studies the health care service cost management for DRG from thepoint of the integration management. Based on the review of the theories on healthcare service cost management and the analysis of the current problems of hospitalscost management in the process of implementing DRG in China, it presents the basictheory and management mode of integrated health care service cost management forDRG and studies the characteristics and problems of the disease cost estimation andcontrol in depth, combined with the integration methods. The major results are asfollowings:First, the dissertation reviews and analyses the research on health care service costmanagement, and then proposes the further main study direction. On that basis, thecentral issues of the approach in the dissertation are raised.Second, the dissertation analyses the influence of DRG on health care servicemanagement, studies the system structure and characteristics, formulates thetheoretical framework of applying the integrated health care service cost managementfor DRG. On that basis, it presents the management mode and framework of theintegrated health care service cost management for DRG, and introduces thecomponents of the structure.Third, to meet the requirement of disease cost management, the dissertation proposesdisease cost data warehouse. And then it proposes the model of single disease anddisease series cost factors influenced expression based on GBOM(Generic Bill ofMaterial), and carries on the mathematical description. Finally, it proposes the modelof disease cost factors influenced reduction based on rough set, and gives an example.Fourth, the dissertation studies the disease cost estimation methods. It proposesdisease cost estimation system structure based on KDD(Knowledge Discovery inDatabases). And then it proposes single disease cost estimation based on SVM andDRG disease series cost estimation based on PSO-SVM.Fifth, the dissertation studies the disease cost control methods.The dissertation adoptspredicting control, and proposes the predicting control mode of disease cost. And then,it adopts EWMA control chart and LSSVM to disease cost control, and proposes disease cost predicting control model based on EWMA control chart and LSSVM, anddisease cost deviations recognition model based on GA-LSSVM.Sixth, the dissertation studies the health care service operation optimization strategiesfor cost. Based on the analysis on problems of health care service operation in China,it proposes disease cost reduction strategies from the points of hospital facility andstaff planning based on queueing theory, system simulation and integer programming.