Methodological Study On DRGs In Comprehensive Hospital Inpatients Of Yunnan Province

Objectives To develop a Methodological system on DRGs(Diagnosis Related Groups) in Yunnan Province, conduct hospitals to formulate reasonable rules for medical charges, control the increasement of medical expenses effectively, provide a scientific information for medical insurance insititution to make rules on hospital charges , so as to promote the deep reform for medical system in Yunnan province.Methods On the basis of reviewing documents, this paper constructed a case mix classification scheme - AID(Automatic Interaction Detection) method, which is a kind of tree structural model. The data we used came from a sample of five comprehensive hospitals , which were a total of 395307 discharge patients. We select hospitalization expenses as a criteria variable and seven grouping variables of case characteristics which including sex, age, main treatment result, accompany disease, complication, operation and marriage status. The analysis of variance method was used to compare the difference of expenses among different groups.Results The average hospitalization expenses for the total of 395307 discharge patients were 4580 yuan, constructed a case mix classification scheme of 592 DRGS by statistical analysis and suggestion from experts. The case mix displayedhomogeneity within groups and heterogeneity among groups, with respect to clinical characteristics and the charges of patients.Conclusion The establishment of case mix classification scheme were based on large size of sampling, it could provide a classification standard and basis for formulating a reasonable standard of hospital charges in Yunnan province.