Calculation of the complication index measurement for DIP payment based on decision tree for spinal stenosis
Li Yunfeng1，Chen Liya1，Yang Yechun2
1 Nanfang Hospital, Southern Medical University, Guangzhou 510515, China;
2 the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangzhou 510405, China
Abstract：Objective To explore the standard cost subdivision scheme and complication index measurement (CCI) of DIP subgroup "spinal stenosis: lumbar interbody fusion, posterior approach", and to provide reference for the improvement of DIP payment scheme and policy formulation by the medical insurance department.Methods The home page data of 1 610 cases of spinal stenosis in a large tertiary hospital in Guangzhou from 2020 to 2022 were selected to screen the main complications of this group. The cost data were further fitted with decision tree model, DIP subgroups of different complications were established, and the complication index of each group was measured. Results The main complications in the spinal stenosis group were hypertension, type 2 diabetes, hyperuricemia and urinary system infection, which occurred in 20.31%, 10.37%, 5.16% and 4.35% cases, respectively. Quantile regression analysis showed that there were statistical differences in total hospitalization costs between the two groups with or without hypertension, type 2 diabetes, urinary tract infection or pneumonia (P<0.05). Four DIP subgroups with spinal stenosis were formed based on the decision tree model. The complication index of the subgroup with hypertension and urinary system infection was 1.04, that of the subgroup with type 2 diabetes was 1.08, and that of the subgroup with other complications was 0.98.Conclusion The complications of spinal stenosis are widely dispersed. The standard cost and complication index of spinal stenosis subdivision program are calculated by using decision tree model, which improves the accuracy of DIP payment and can provide reference for DIP to make subdivision program and improve the standard score database.
李云峰，陈莉雅，杨业春. 基于决策树的“椎管狭窄”DIP付费的并发症指数测算[J]. 中国医院统计, 2023, 30(5): 334-338.
Li Yunfeng，Chen Liya，Yang Yechun. Calculation of the complication index measurement for DIP payment based on decision tree for spinal stenosis. journal1, 2023, 30(5): 334-338.
