| BackgroundIn recent years,with the rapid development of economy and society,many changes have taken place in social environmental factors,scientific and technological factors,life style and so on,and the disease spectrum of population,life span and health needs of people have also been affected.for example,the progress of technology has led to the improvement of disease treatment,the extension of people’s life expectancy,the acceleration of the process of aging society,and the increasing health needs of the people.Environmental factors,changes in life lead to changes in human disease spectrum and other factors,continue to urge people to enhance the demand for health services,so that the cost of existing medical services continues to increase,it is urgent to accelerate the reform of medical payment methods.ObjectiveThis study applies the concept of grouping related to disease diagnosis,looks for the influencing factors of the total cost of cooking and hospitalization based on the hospitalization cost of acute appendicitis,and uses the decision tree model to group the internal secondary cases of the disease and refine the combination of disease species.and use historical data to fit the standard cost,security costs,upper limit,weight of disease and so on.To provide a basis for health management departments and medical insurance departments in the reform of medical payment methods.MethodsTo systematically analyze and study the related literature on the theory of disease diagnosis and the factors affecting the total hospitalization cost of patients with acute appendicitis,collect the data of medical records,and use single factor statistical analysis,multi-factor regression analysis and decision tree model to analyze the case mix of patients with acute appendicitis from the perspective of DRGs.According to the results of the second grouping of diseases,the standard cost,security costs,upper limit,and weight of diseases are set by means and quartiles.ResultsAt the end of this study,4066 cases were included in this study.The main results are as follows:(1)the single factor statistical analysis and multi-factor linear regression analysis showed that the total hospitalization cost of the patients was taken as the dependent variable,and the general demographic factors,disease characteristics and treatment methods of the patients were taken as independent variables.the results showed that there was a significant correlation among the days of hospitalization,the mode of marriage,the mode of operation and the type of hospital from which the case came from.The results showed that there was a significant correlation(P < 0.05).(2)the statistical variables with significant significance were found by multi-factor linear regression analysis as grouping nodes,and the decision tree model was used to carry out the secondary combination of diseases.The grouping results showed that there were 10 acute appendicitis patients.The coefficient of variation test showed that the difference between the groups was good,and the CV values were all less than 0.8.(3)the standard cost,upper limit,lower limit and disease weight of disease cost after grouping are set by using the calculation methods of average and quartile.The results show that the highest standardized disease cost is 15569 yuan and the lowest is 3047 yuan.and the weight of disease types ranges from 0.30 to 1.52.ConclusionsBased on the grouping concept of disease diagnosis related group system,the second grouping of acute appendicitis in Anhui Province has a good result by using statistical methods such as single factor analysis,multi-factor linear regression analysis and decision tree model,which is divided into 10 DRGs groups.The standard cost,security costs,upper limit,and weight of disease are established by means of average and quartile.The purpose of this study is to provide theoretical support for health management departments and medical insurance departments to formulate a payment system according to the relevant groups of disease diagnosis. |
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