Study On The In-patients Costs Of Breast Cancer Patients In Guangxi Based On DRGs

ObjectiveThe in-patients costs of breast cancer was analyzed with statistical analysis method and decision tree classification method.The in-patients costs of each DRGs group was obtained based on the different combination of hospitalization days,hospital level,treatment,complications and complications.This can promote the DRGs payment system for Guangxi and the other provinces,improve the medical insurance system,and provide decision-making reference to further optimize the allocation of medical resources.MethodsThe data of this study includes 199 hospitals at all levels in Guangxi,with a total of 3,5162 cases of breast cancer.Through descriptive statistical analysis,the relationship between each variable and the in-patients costs was analyzed by single factor variance.Correlation analysis was used to compare the correlation between variables and the in-patients costs.Using multiple linear regression analysis,with the in-patients costs as the dependent variable,and variables getting by the above step which obviously correlated as the independent variable,get the influence factors of breast cancer patients in the the in-patients costs regression model.The regression equation was evaluated by R squared and residual histogram and residual probability graph.The decision tree was built using the chi-square automatic interactive detection(CHAID)algorithm,and then get the DRGs group.Using the coefficient of variation(CV)and reductionvariance(RIV),the homogeneity and inter-group heterogeneity ofDRGs were evaluated respectively.Results(1)Single factor analysis result of each variable and thein-patients costs.The median cost of the total cost was 15421.25 yuan,with the largest cost of western medicine charge,4274.00 yuan,accounting for 29.87% of the total cost.The mean age of the patients was 50.41 years,and the mean length of hospitalization was 15.99 days.The proportion of grade iii hospitals in different hospitals was the largest,accounting for 67.98%,and the median cost was 196,67.13 yuan.In the sample,the proportion of cases without comorbidity or complication group was 49.26%,and the median cost was 14580.52 yuan.The proportion of patients with complications or complications was 50.74%,and the median total cost was higher than that of the group with no complications or complications,which was 16233.13 yuan.The proportion of patients receiving surgical treatment was higher than those with conservative treatment,with 57.52%.The median total cost was significantly higher than that of the conservative treatment group,which was 19351.86 yuan,and the median total cost of the conservative treatment group was 7008.62 yuan.The total cost difference of each variable was statistically significant(P<0.05).(2)Correlation analysis results showed that the correlation between age and total expenses was not statistically significant(P>0.05),and the remaining variables were significantly correlated with the dependent variable-total cost(P<0.05).(3)We can get the multiple linear regression equation by regression analysis : the Log(total cost)=2.75 + 0.67 * Log(hospitalization days)+ 0.25 * hospital level + 0.09 * treatment-0.11 * hospital order + 0.01 * complications and complications.The fitting condition and fitting of the equation are good.(4)The DRGs group results showed that the cases were grouped into 24 DRGs by the number of hospitalized days,hospital level,treatment,complications and complications.The groups results show the general trend that the total cost increases with the gradual increase in hospital stay,and the total cost of hospital whit higher level is more than the lower,the total cost of surgery groups is higher than the groups without surgery,the total cost of complications and complications groups is higher than the groups without complications and complications.The grouping is reasonable and the effect is good.ConclusionsWestern medicine charge is the biggest financial burden for breast cancer patients.Reducing the number of hospital stays in breast cancer patients can effectively control medical expenses.In recent years,the control of drugs in our region has achieved remarkable results in breast cancer single disease.In 2017,the prevention and treatment of breast cancer in our region has achieved remarkable results.The cost of breast cancer is divided into 24 related groups according to the combinations of DRGs,and the grouping is reasonable and effective.