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目的对安庆市某三甲医院子宫平滑肌瘤病例进行DRGs分组,探索该病种医保付费的补充方法。方法选取某院2013年1月-2015年11月以子宫平滑肌瘤为主要诊断的病例,运用决策树模型中的卡方自动交叉诊断法(CHAID),建立子宫平滑肌瘤患者的DRGs病例组合模型,比较分组费用与目前医保费用支付标准的差异。结果有效的DRGs分组有7个,不同的病例组合对住院医疗费用的影响有统计学意义,P<0.05;与现行医保费用标准之间的差异有统计学意义。结论子宫平滑肌瘤的DRGs分组综合住院天数、治疗方式、伴随的并发症/合并症等方面,通过制定符合相应组别的患者住院费用标准,有利于减轻患者的经济负担,可为医疗费用支付方式改革提供参考。
Objective To classify the cases of uterine leiomyomas in a top three hospital in Anqing and explore the supplementary methods of medical insurance payment. Methods From January 2013 to November 2015 in our hospital, a case of uterine leiomyoma was selected as the main diagnosis. The chi square auto-cross diagnosis (CHAID) in the decision tree model was used to establish a combination of DRGs in uterine leiomyomas Model to compare the difference between the grouping cost and the current payment standard of medical insurance. Results There were 7 groups of effective DRGs, and the impact of different case combinations on hospitalization expenses was statistically significant (P <0.05). There was significant difference between the current medical insurance cost standard and the current medical insurance cost standard. Conclusions The DRGs group of uterine leiomyoma can be used to reduce the financial burden of patients and to pay for the medical expenses through comprehensive hospitalization days, treatment methods, complication / comorbidity and other aspects. Way to provide a reference for the reform.