CAJ | 학술논문

目的：通过对儿童热液烫伤患者DRGs分组，筛选出异常费用病例，分析其成因，提出控制不合理费用的对策。方法采用卡方自动交互监测（ CHAID）对1290例病例进行DRGs分组，制定出各组患者费用合理区间，计算各组线外患者和线外患者比例，分析其产生原因。结果以烧伤面积、治疗结果、是否输血、是否休克作为分类节点将病例分为6个DRGs组合。线外患者比例和线外费用比例分别为6．20％和8．39％。不合理费用产生原因主要是不落实医疗规范和患儿家属缺乏相关知识。结论 DRGs分组可以排除疾病严重程度、病情复杂性对医疗资源消耗的影响，利于查找合理费用区间以外的患者，有针对性地进行费用和质量控制。
목적：통과대인동열액탕상환자DRGs분조，사선출이상비용병례，분석기성인，제출공제불합리비용적대책。방법채용잡방자동교호감측（ CHAID）대1290례병례진행DRGs분조，제정출각조환자비용합리구간，계산각조선외환자화선외환자비례，분석기산생원인。결과이소상면적、치료결과、시부수혈、시부휴극작위분류절점장병례분위6개DRGs조합。선외환자비례화선외비용비례분별위6．20％화8．39％。불합리비용산생원인주요시불락실의료규범화환인가속결핍상관지식。결론 DRGs분조가이배제질병엄중정도、병정복잡성대의료자원소모적영향，리우사조합리비용구간이외적환자，유침대성지진행비용화질량공제。
Objective To find out the expenses cases by diagnosis related groups method in pediatric hot liquid scald inpatients.Analyze its causes, and put forward the management to control the unreasonable costs. Methods Selecting a burn center of military tertiary hospital as the research object .1290 medical record data are divided into groups by Chi-Square Automatic Interaction Detection CHAID methods.Make costs reasonable interval, and take the patients of outline in each group.Then analyze its causes.Results 6 DRGs groups were formed by Burns, treatment outcome, blood transfusion and shock.The proportion of off-line patients and the proportion of off-line costs were 6 .20%and 8 .39%.The main reason of unreasonable cost were medical abnor-mal and no information of children parents.Conclusion The method can reflect influence about the severity and complexity of the disease for medical resource consumption.And it can find out the cases who have extra expen-ses.The method can be targeted for expenses cost and medical quality control.