UNASSIGNED: We investigated the factors influencing the hospitalization cost of patients with pulmonary tuberculosis and grouped cases based on a decision tree model to provide a reference for enhancing the management of diagnosis-related groups (DRGs) of this disease.
UNASSIGNED: The data on the first page of the medical records of patients with the primary diagnosis of pulmonary tuberculosis were extracted from the designated tuberculosis hospital. The influencing factors of hospitalization cost were determined using the Wilcoxon rank sum test and multiple linear stepwise regression analysis, and the included cases were grouped using the chi-squared automated interaction test decision tree model, with these influential factors used as classification nodes. In addition, the included cases were grouped according to the ZJ-DRG grouping scheme piloted in Zhejiang Province, and the differences between the two grouping methods were compared.
UNASSIGNED: The length of hospital stay, respiratory failure, sex, and age were the determining factors of the hospitalization cost of patients with pulmonary tuberculosis, and these factors were incorporated into the decision tree model to form eight case combinations. The reduction in variance (RIV) using this grouping method was 60.60%, the heterogeneity between groups was high, the coefficients of variance ranged from 0.29 to 0.47, and the intra-group difference was small. The patients were also divided into four groups based on the ZJ-DRG grouping scheme piloted in Zhejiang Province. The RIV using this grouping method was 55.24, the differences between groups were acceptable, the coefficients of variance were 1.00, 0.61, 0.77, and 0.87, respectively, and the intra-group difference was significant.
UNASSIGNED: When the pulmonary tuberculosis cases were grouped according to the duration of hospital stay, respiratory failure, and age, the results were rather reasonable, providing a reference for DRG management and cost control of this disease.
■我们基于决策树模型对肺结核患者住院费用的影响因素进行了调查,并对病例进行了分组,为加强该病诊断相关组(DRGs)的管理提供参考。
■初诊肺结核患者的病历首页数据是从指定的结核病医院提取的。采用Wilcoxon秩和检验和多元线性逐步回归分析确定住院费用的影响因素,并使用卡方自动交互测试决策树模型对纳入的案例进行分组,将这些影响因素用作分类节点。此外,根据浙江省试行的ZJ-DRG分组方案对纳入病例进行分组,并比较两种分组方法的差异。
■住院时间,呼吸衰竭,性别,和年龄是肺结核患者住院费用的决定因素,并将这些因素纳入决策树模型,形成8个案例组合。使用这种分组方法的方差(RIV)减少了60.60%,群体之间的异质性很高,变异系数为0.29~0.47,组间差异较小。根据浙江省试行的ZJ-DRG分组方案,将患者分为四组。使用这种分组方法的RIV为55.24,组间差异是可以接受的,变异系数分别为1.00、0.61、0.77和0.87,组内差异有统计学意义。
■当肺结核病例根据住院时间分组时,呼吸衰竭,和年龄,结果相当合理,为本病的DRG管理和费用控制提供参考。