| 摘要: |
| 目的：通过引入病例临床复杂性水平计算原理进行DRG细分组方法的探讨研究，为探索符合我国国情的细分组分组方法提供借鉴参考。方法：由临床专家对合并症并发症临床复杂性水平进行评分，应用病例临床复杂性水平计算模型计算每例病例的临床复杂性水平值，采用CART模型完成DRG细分组的划分，并对细分组结果进行秩和检验。结果：9个女性生殖系统手术治疗类DRG基本组被划分成18个DRG细分组，经检验各基本组内不同DRG组间住院费用和住院天数差异均有统计学意义。结论：病例临床复杂性水平计算方法的应用提高了DRG细分组结果的准确性；病案质量和编码的统一是保证分组结果合理的关键因素。 |
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| Study on Surgical DRG Grouping Method in Female Reproductive System |
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| Abstract: |
| Objective: To explore reasonable methods of subdividing Adjacent DRG into DRG by introducing PCCL principle and provide appropriate DRG grouping method in line with Chinese national conditions. Methods：Clinical complexity level of each complications or comorbidities was assigned by clinicians. Patient clinical complexity level (PCCL) model was selected to calculate the clinical complexity scores of cases. Each Adjacent DRG was subdivided into DRG groups by CART model. The rank-sum test was applied to test the statistical significance of the grouping results. Results: 9 surgical Adjacent DRGs were subdivided into 18 DRG groups. There were statistical significance in the differences of hospitalization expenses and Length of stay between different DRG groups in each adjacent group. Conclusion: PCCL model showed high performance in DRG subdivision. The unification of the quality of medical records and coding is the key factor to ensure the reasonable grouping results. |
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