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目的探讨适合新疆地区结节性甲状腺肿患者住院费用的DRGs病例组合方案。方法采用单因素方差分析和多元线性逐步回归的方法对2011年1月至2014年12月主要诊断为结节性甲状腺肿的有效病案2131份进行病例分组,以主要影响因素为节点将病例分组,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性别、年龄、住院天数、伴随疾病、有无手术及年份,标准偏回归系数分别为0.04、0.20、0.26、0.18、0.59、0.22,P值均<0.01,调整R2=0.6837。病例组合后分为8个诊断相关组,各组间费用有统计学差异,F=264.6510,P<0.01,计算出每个诊断相关组的标准费用参考值可解释68.37%的医疗消费。结论以有无手术作为节点对结节性甲状腺肿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,保证医院质量与安全。
Objective To explore the combination of DRGs inpatients with nodular goiter in Xinjiang. Methods One-way ANOVA and multivariate linear stepwise regression were used to classify 2131 effective cases of nodular goiter diagnosed between January 2011 and December 2014. The main influencing factors were grouping the cases into groups, And calculate the standard cost of each group. Results The main factors influencing the hospitalization costs were gender, age, days of hospitalization, concomitant diseases, presence or absence of surgery and years, the standard partial regression coefficients were 0.04,0.20,0.26,0.18,0.59,0.22, P <0.01, adjusted R2 = 0.6837. The cases were divided into 8 groups and the costs of each group were statistically different (F = 264.6510, P <0.01). Calculating the standard cost reference for each diagnosis-related group could explain 68.37% of the medical expenditure. Conclusion It is feasible to classify the hospitalization costs of patients with nodular goiter with or without operation. The DRGs research is helpful to standardize the diagnosis and treatment and ensure the quality and safety of the hospital.