| Objective : Through the DRGs system of a tertiary hospital of traditional Chinese medicine in Tianjin,the information on the front page of the medical records of hospitalized patients with stroke in the acupuncture department was collected,and the evaluation indexes in the diagnosis related groups(DRGs)were analyzed.The general situation of stroke patients in the acupuncture department of a tertiary hospital of traditional Chinese medicine in Tianjin and the influencing factors of hospitalization were retrospectively studied to explore the influencing factors of DRGs grouping and hospitalization.Methods : Through the disease diagnosis related platform(DRGs)of a tertiary hospital in Tianjin to find and export the research data,all the medical records of discharged patients from August 1,2020 to August 31,2021 were screened and retrospectively studied.The data were sorted and EXCEL database was established.The analysis factors included gender ratio,age distribution,stroke type,number of hospitalizations,main diagnosis,other diagnosis,DRGs description group,CMI value,high,medium and low risk and death group,time consumption index and cost consumption index.In study 1,SPSS 26.0 was used to establish the data set and statistical analysis.In the measurement data,the data that did not conform to the normal distribution were represented by median,quartile spacing(M(P25,P75)),and the count data were represented by frequency(n)and percentage(%).In study 2,Mann-Whitney U test or Kruskal-Willis H test were used to infer the differences between two variables or multiple variables by single factor analysis.Artificial neural network was used for multivariate analysis.P ≤ 0.05 indicated that the difference was statistically significant,and P < 0.01 indicated that the difference was statistically significant.Results : A total of 9637 cases of stroke discharged from the acupuncture department were included.In study 1,(1)Male(66.09 %)was more than female(33.91 %);(2)The elderly patients over 58 years old were the most(77.27 %),and those less than or equal to 45 years old were the least(5.47 %);(3)The incidence of ischemic stroke(92.08 %)was higher than that of hemorrhagic stroke(7.92 %);(4)The frequency of hospitalization times gradually decreases with the increase of hospitalization times;(5)The hospitalization days of 48.88 % patients were 8-14 days,the median was 14 days;(6)In the admission time,the number of patients increased significantly from February to April 2020;(7)In DRGs group,the number of patients in BR23 group was the largest(67.46 %),and that in BR11 group was the smallest(1.61 %).(8)In the death risk classification,there were up to 6501 patients in the low-risk group and 155 patients in the high-risk group with the highest mortality rate of 0.645 %;(9)Among the complications,92.1 % of patients had one or more complications,and 86.53 % of them had cardiovascular diseases.Study 2 : The median length of hospital stay was 14 days,the average was 17.60 days,the minimum was 2 days,the maximum was 60 days.Univariate analysis of hospitalization days showed that gender had no effect on hospitalization days(P > 0.05).Age,stroke type,number of hospitalizations,DRGs grouping,number of complications,and whether combined with cardiovascular disease had an effect on hospitalization days(P < 0.001).The results of ANN model analysis showed that the importance of influencing hospitalization days of stroke patients discharged from acupuncture department was time consumption index(0.803),stroke type(0.075),case group(0.064),cost consumption index(0.025),hospitalization times(0.019),number of complications(0.006),age(0.006),and whether complicated with vascular diseases(0.002).The analysis of hospitalization expenses showed that the median of total hospitalization expenses was 209918.34 yuan,the cost of drugs was 5209.06 yuan,the cost of consumables was 738.44 yuan,and the cost of acupuncture treatment was 2808.00 yuan.The coefficient of variation of hospitalization expenses in each group was less than 1.The results of single factor analysis of hospitalization expenses showed that gender had a statistically significant impact on hospitalization expenses(P < 0.05).Age,stroke type,hospitalization times,hospitalization days,DRGs grouping,the number of complications,and whether cardiovascular diseases were associated with hospitalization expenses had a statistically significant impact(P < 0.001).The results of multivariate analysis of ANN model showed that the influencing factors of hospitalization expenses were as follows : cost consumption index(0.763),case group(0.078),stroke type(0.071),time consumption index(0.047),hospitalization times(0.014),hospitalization days(0.012),number of complications(0.006),age(0.005),and cardiovascular disease(0.003).Conclusion :1.The order of importance of factors affecting hospitalization days is : type of stroke,number of hospitalizations,number of comorbidities,age,and cardiovascular disease.2.Among the related factors affecting hospitalization expenses,the hospitalization expenses of stroke patients over 70 years old in acupuncture department are the highest;hemorrhagic stroke costs higher than ischemic stroke;there was a positive correlation between the number of comorbidities and hospitalization expenses,and the hospitalization expenses of patients with cardiovascular diseases were higher.There is a negative correlation between the number of hospitalizations and hospitalization expenses. |
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