Study On DRGs Grouping And Hospitalization Expense Standard Based On Data Mining For Malignant Tumor Disease

As a management tool,diagnosis related groups(DRGs)has shown a strong vitality since it was first presented in 1979.All countries are actively exploring the DRGs which is suitable for the development of medical and health in their country and apply DRGs to medical service performance evaluation and medical insurance payment study,which improves the level of medical service and reduces medical costs.Under the background of the rapid growth of medical expenses in our country,it is of great importance to explore the combination of DRGs grouping and medical insurance payment.But now the research on DRGs in China is still in its infancy.There is not a unified authoritative DRGs standard for medical workers as well as the relevant theory and practice is gradually advancing and trying process.This paper applies medical records data from a first class hospital in Beijing exploring grouping model and determining the standard case-mix cost for malignant tumor disease based on data mining.Specifically,we extract all the relevant attributes in medical record homepage.For the purpose of not discarding the important attributes,we reduce the redundant attributes based on rough set.On the basis of the analysis of variance analysis and multivariate statistical data of malignant tumors,we construct a DRGs classifier and get reasonable classification results which include 19 DRGs,each of which reflects main diagnosis,individual differences and resource consumption,using decision tree classification data mining methods.Then,we calculate the standard cost of each DRGs adopting the method of relative weight as well as considering the DRGs disease change trend adjustment coefficient?_i and determine the more reasonable case-mix standard cost.Finally we provide helpful suggestion for malignant diseases patients'medical insurance payment management.In the direction of case-mix and calculation of standard cost for malignant tumor cases,this paper studies the malignant tumor cases“grouping”and“pricing”process,in order to provide a reference for medical practitioners and academic researchers.