引用本文: 权晓雯,王艳,杨圆圆,等.基于分位数回归和决策树模型的跌倒患儿控费组合分析*[J].中国卫生经济,2023,42(10):45-49.[点击复制] Quan Xiaowen,Wang Yan,Yang Yuanyuan,et al.Combination Analysis of Cost Control for Children with Falls Based on Quantile Regression and Decision Tree Mod⁃ el[J].CHINESE HEALTH ECONOMICS,2023,42(10):45-49.[点击复制]
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基于分位数回归和决策树模型的跌倒患儿控费组合分析*
权晓雯,王艳,杨圆圆,霞依丹·阿不都色米,芦浩雅,罗振,方娴
0
(新疆医科大学公共卫生学院 乌鲁木齐 830011;新疆医科大学学报编辑部 乌鲁木齐 830011;新疆医科大学第一附属医院医务管理科 乌鲁木齐 830011)
摘要:
目的:探寻0~6岁跌倒患儿的DRG病例组合及住院费用标准,为科学分析住院费用、制定针对性控费措施提供参考依据。方法:选取新疆规模最大的2所三级甲等公立医院及其医联体内下属的6所二级甲等公立医院2010—2021年住院病案首页数据库中因跌倒住院的2 773例0~6岁患儿为研究对象,采用多元线性回归模型、分位数回归模型、决策树模型进行病例组合分析。结果:跌倒患儿住院费用总计24 571 782.09元,平均住院费用5 543.36元。以住院日为影响变量,以医院等级、居住地区、入院状态、伤害性质、伤害部位、手术等级、是否转科、并发症及支付方式等主要影响因素为分类节点构建15个DRG病例组合,并制定相应住院费用标准和病种权重,住院费用超限病例共340例。结论:利用分位数回归和决策树模型构建跌倒患儿DRG病例组合较合理,有利于控制该病种的住院费用,减轻患儿家庭经济负担,为医疗费用支付方式改革提供参考。
关键词:  跌倒  儿童  疾病诊断相关分组  住院费用
DOI:
投稿时间:2023-07-28
基金项目:新疆维吾尔自治区自然科学基金项目(2020D01C164)
Combination Analysis of Cost Control for Children with Falls Based on Quantile Regression and Decision Tree Mod⁃ el
Quan Xiaowen,Wang Yan,Yang Yuanyuan,Xia Yidan·Abudusemi,Lu Haoya,Luo Zhen,Fang Xian
(The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830011 , China)
Abstract:
Objective: To explore the DRG case combination and hospitalization expense standard of children aged 0~6 years old who fell, and to provide references for scientific analysis of hospitalization expenses and formulation of targeted cost control measures. Methods: A total of 2 773 children aged 0~6 who were hospitalized due to falls in the homepage database of inpatient medical records from 2010 to 2021 in 2 class A tertiary hospitals and 6 class A secondary hospitals in Xinjiang were selected, and multiple linear regression model, quantile regression model and decision tree model were used for case combination analysis. Results: The total hospitalization expenses of children who fell were 24 571 782.09 yuan, and the average hospitalization expenses were 5 543.36 yuan. Taking the length of stay as the influencing variable, and the main influencing factors (P<0.05) such as hospital grade, residential area, admission status, injury nature, injury site, operation grade, whether to change majors, complications and payment method as the classification nodes, 15 DRG case combinations were constructed, and the corresponding hospitalization expenses standards and disease weights were formulated. There were 340 cases with hospitalization expenses exceeding the standard. Conclusion: It is reasonable to construct the DRG case combination of children with falls by fractional regression and decision tree model, which is beneficial to control the hospitalization expenses, reduce the financial burden of children’s families, and provide a basis for the reform of medical expenses payment methods.
Key words:  fall  children  Diagnosis Related Group  hospitalization expense

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