A Decision Tree Model-based Study on the Grouping of Hospitalization Expenses of Type 2 Diabetes Patients in a Traditional Chinese Medicine Hospital

Xue Zhang, Jianke Ren, Xin Wang, Lijun Liang
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Abstract

Objective To discover the case-mix approach for TCM treatment of dominant disease type 2 diabetes patients and to analyze the hospitalization expense standards for different combinations of patients to provide theoretical references for better participation of TCM hospitals in the DRG payment method as well as reasonable regulation of hospitalization expenses for TCM type 2 diabetes patients in the future. Methods Case data were collected from 1,171 patients discharged with a principal diagnosis of type 2 diabetes from September 2021 to April 2023 from a tertiary care Chinese medicine hospital in Tianjin. Univariate and multivariate stepwise regression analyses determined categorical node variables. The decision tree model was used to perform case combinations and to analyze the expense standards and weights of different groups of disease types. Results The number of days of hospitalization, conditions in admission, and whether complicated cardiovascular and cerebrovascular diseases are the main factors affecting the hospitalization expense of type 2 diabetes patients in Chinese medicine hospitals, and the decision tree model was used to group the patients to form nine groups of patient case combinations. The standard of hospitalization expense for each combination was set reasonably. Conclusion The grouping results are more satisfactory, and the grouping scheme and hospitalization expense standards can provide a scientific basis for DRG grouping, adopting differentiated expense management, and improving the medical resource efficiency in TCM hospitals.
基于决策树模型的中医院 2 型糖尿病患者住院费用分组研究
摘要] 目的 探索中医药治疗优势病种2型糖尿病患者的病例组合方法,分析不同组合患者的住院费用标准,为今后中医医院更好地参与DRG支付方式以及合理调控中医药治疗2型糖尿病患者的住院费用提供理论参考。方法 收集天津市某三级甲等中医医院2021年9月至2023年4月主要诊断为2型糖尿病的1171例出院患者的病例数据。单变量和多变量逐步回归分析确定了分类节点变量。采用决策树模型进行病例组合,分析不同病种组的费用标准和权重。结果 住院天数、入院病情、是否并发心脑血管疾病是影响中医院 2 型糖尿病患者住院费用的主要因素,采用决策树模型对患者进行分组,形成 9 组病例组合。合理设定各组合的住院费用标准。结论 分组结果较为理想,分组方案和住院费用标准可为 DRGs 分组、采取差异化费用管理、提高中医医院医疗资源使用效率提供科学依据。
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