Research on grouping hospitalization expenses of patients with choledocholithiasis based on decision tree
Yin Yuhua1， Wu Huatun2，Zhu Jianqian2
1 Chengbei Quality Management Department, Affiliated Hangzhou First People′s Hospital, Zhejiang University School of Medicine, Hangzhou 310000, China;
2 Hubin Quality Management Department, Affiliated Hangzhou First People′s Hospital, Zhejiang University School of Medicine, Hangzhou 310000, China
Abstract：Objective To study the case mix mode and cost payment standard of patients with common bile duct stones, so as to provide a reference for medical institutions to formulate correct hospitalization expenses grouping and improve medical efficiency. Methods The data came from the home page information of 3 990 patients with common bile duct stones diagnosed and treated in a large tertiary general hospital in Zhejiang Province from 2017 to 2020. After the relevant indicators were selected, multiple stepwise regression analysis was used to analyze the influencing factors of hospitalization expenses. The selected influencing factors were incorporated into the decision tree model, and the decision tree E-CHAID method was used to construct the hospitalization expense grouping plan and payment standard for choledocholithiasis. Results The number of days of hospitalization, surgery, and age were the classification nodes of the decision tree. The decision tree was divided into 8 groups. The coefficient of variation -CV- within each group was less than 0.4. The reduction of inter-variance was 0.67. The intra-group homogeneity and inter-group heterogeneity were good. Conclusion Using the decision tree E-CHAID method to group common bile duct stone cases into hospitalization expenses is scientific and reasonable. Medical institutions in various regions can verify the grouping based on local data and optimize the grouping plan.
殷玉华，吴华氽，朱健倩. 基于决策树的胆总管结石患者住院费用分组研究[J]. 中国医院统计, 2021, 28(4): 321-324.
Yin Yuhua，Wu Huatun，Zhu Jianqian. Research on grouping hospitalization expenses of patients with choledocholithiasis based on decision tree. journal1, 2021, 28(4): 321-324.
［1］LIM S U, PARK C H, KEE W J, et al. Intraductal ultrasonography without radiocontrast cholangiogramin patients with extrahepatic biliary disease［J］. Gut Liver, 2015, 9(4):540-546.
［2］何文博,张旭,韩雪,等.某市三级医院缺血性脑卒中患者住院费用及病例组合分析［J］.中国预防医学杂志,2019,20(2):86-91.
［3］郑真真.中国育龄妇女的生育意愿研究［J］.中国人口科学,2004(5):73-78.
［4］韩栋,魏凌云,章莹,等.妇婴疾病诊断相关组的构建与比较研究［J］.中国卫生统计,2016,33(6):986-988.
［5］赵一鸣.对“回归树的建模与应用”一文的几点补充［J］.中华预防医学杂志,2003,37(2):69-70.
［6］许琼琼,肖静,沈康,等.基于决策树模型食管癌病例组合研究［J］.中国卫生统计,2016,33(4):563-566.
［7］沈志浩,黄晓睛,徐雁鸣,等.基层医院腹股沟疝疾病诊断相关分组研究与住院费用标准的合理化探讨［J］.中国卫生统计,2016,33(2):304-306.
［8］王珊,饶克勤,刘丽华.我国按病种付费实施现况及国际DRGs支付借鉴［J］.中华医院管理杂志,2015,31(2):81-83.
［9］高建民,郑古峥玥,詹梅,等.基于疾病诊断相关组合的住院费用标准合理化探讨［J］.中国卫生经济,2013,32(1):22-24.
［10］杜剑亮,刘骏峰,陈倩.不同决策树算法建立DRGs模型的差异［J］.中国病案,2014,15(7):38-41.
［11］薛允莲.logistic回归结合决策树技术在冠心病患者住院费用组合分析中的应用［J］.中国卫生统计,2015,32(6):988-989.
［12］刘汉俊.腹腔镜与开腹手术对胆总管结石的治疗效果研究［J］.中国现代药物应用,2020,14(24):56-58.
［13］邵慧丽,宁传英.基于E-CHAID算法胆囊结石患者DRGs分组研究［J］.中国卫生统计,2019,36(4):554-555.
