摘要
目的利用出院患者病案数据进行病例组合,探讨应用病例组合方案进行公立医院绩效考评与成本管控的可行性。方法基于CHAID决策树模型,以住院费用为目标变量,选取手术操作级别等作为预测变量,建立病例组合方案;对分组结果进行统计学检验,评价组内同质性与组间异质性,测量相对权重对住院费用的拟合优度。结果建立了覆盖某公立医院全部病种的病例组合方案,分组结果组间差异具有统计学意义,组内同质性与组间异质性较高,相对权重对住院费用拟合情况良好。结论通过CHAID决策树模型建立的病例组合方案评价结果良好,可用于开展医疗质量评价与病种管理。
Objective To explore the feasibility of the performance appraisal and cost control of the public hospital by using the case mix scheme.Methods Based on the CHAID decision tree model,the hospital cost was used as the target variable,and the factors including the operation level as the prediction variable for the establishment of case mix scheme.The statistical analysis was carried out on the grouping result,the heterogeneity of the homogeneity and the group was evaluated,and the optimal degree of the relative weight was measured.Results The combination scheme of total cases of the whole disease in a public hospital was established,and the differences between the group results were statistically significant,and the homogeneity and the heterogeneity of the group were higher,and the relative weights fit well to the hospitalization costs.Conclusion The evaluation results of the case mix scheme based on CHAID decision tree model were good and can be used for medical quality evaluation and disease management.
作者
姜德超
徐凤琴
JIANG Dechao;XU Fengqin(Sun Yat-sen Memorial Hospital,Sun Yat-sen University,Guangzhou,Guangdong,510120,China)
出处
《中国卫生质量管理》
2019年第3期37-40,共4页
Chinese Health Quality Management
关键词
公立医院
决策树
病例组合
Public Hospital
Decision Tree
Case Mix
