乳腺癌患者住院费用的诊断相关分组研究

目的探讨适合新疆地区乳腺癌患者住院费用的DRGs病例组合方案。方法一采用单因素分析、方差分析和多元线性逐步回归的方法对2010年1月1日至2012年12月31日主要诊断为乳腺癌的有效病案3788份进行病例分组，以主要影响因素为截点将病例分组，并计算各组的标准费用。结果影响住院费用的主要因素依次为住院天数、是否化疗、是否手术、是否放疗，标准回归系数分别为0．557、-0．312、-0．284．-0．212，P值均〈0．01，调整R2=0．826。病例组合后分为5个诊断相关组，各组间费用有统计学差异，F=180．6587，P〈0．01，计算出每个诊断相关组的标准费用参考值可解释70％的医疗消费。结论以治疗手段为截点对乳腺癌患者住院费用进行分组具有可行性，DRGs研究有利于规范诊疗行为。

Study on DRGs of In-patient Expenses of Breast Cancer

Objective To explore the DRGs scheme which is suitable for breast cancer？patients in Xinjiang area. Methods The ef- fective medical records of the 3788 breast cancer inpatients from January 1, 2010 to December 31, 2012 are divided into several groups by statistic methods such as single statistical method, ANOVA and multiple linear stepwise regression. The samples are divided according to primary factors, and the standard expense of each group is calculated. Results The main factors are in-patient days, whether there is oper- ation, whether there is chemotherapy, whether there is radiotherapy. The standard regression coetticient were 0.557,-0.312,-0.284,-0.212, P〈0.01,there were five diagnosis related groups, there was statistically significant, F=180.6587, P〈0.01. The standard of fee for service in the hospital of every group is calculated can explain 70% of the medical consumption. Conclusion The hospitalization expenses of patients with breast cancer are divided into case groups according to the treatment measures is feasible. Study on DRGs is conducive to standardize the di- agnosis and treatment behavior.