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目的:通过引入病例临床复杂性水平计算原理进行疾病诊断相关分组(DRG)细分组方法的探讨研究,为探索符合我国国情的细分组分组方法提供借鉴参考。方法:由临床专家对合并症与并发症临床复杂性水平进行评分,应用病例临床复杂性水平计算模型计算每例病例的临床复杂性水平值,采用CART模型完成DRG细分组的划分,并对细分组结果进行秩和检验。结果:9个女性生殖系统手术治疗类DRG基本组被划分成18个DRG细分组,经检验各基本组内不同DRG组间住院费用和住院天数差异均有统计学意义。结论:病例临床复杂性水平计算方法的应用提高了DRG细分组结果的准确性;病案质量和编码的统一是保证分组结果合理的关键因素。
OBJECTIVE: To explore the method of subdivision of disease diagnosis group (DRG) by introducing the calculation principle of clinical complexity level of case, and to provide reference for exploring subdivision grouping method in line with China’s national conditions. Methods: Clinical experts evaluated the clinical complexity of complications and complications, calculated the clinical complexity level of each case by using the clinical complexity level calculation model, and divided the DRG subgroups by CART model. Subdivision group results for rank sum test. Results: Nine female genital system surgical treatment DRG basic groups were divided into 18 DRG subgroups. The differences of hospitalization costs and hospitalization days between the different DRG groups in each basic group were statistically significant. Conclusion: The application of the calculation method of clinical complexity level improves the accuracy of DRG subdivision. The unification of medical record quality and coding is the key factor to ensure the grouping result is reasonable.