Hospitalization expense estimation and judgment method for single disease

Abstract

The invention discloses a hospitalization expense estimation and judgment method for single disease. The method comprises: cleaning abnormal data, screening out qualified samples, and establishing a sample database; neatening the samples and extracting influence factors related with hospitalization expense estimation and judgment of the single disease; performing expense interval estimation according to the number of samples, wherein the number of samples has to be greater than 10; if the number of samples is greater than 50, at first, trying to delete a maximum value or a minimum value through algorithm iteration, wherein the rest samples are reserved verification samples; then verifying a sample distribution pattern, limiting the residual rate of the samples, and normalizing the samples to estimate an expense interval; and if the number of samples is smaller than or equal to 50 and greater than 10, performing t distribution estimation and directly calculating expense estimation of a confidence interval.

Description

technical field [0001] The invention relates to a method for estimating and judging hospitalization expenses of a single disease. Background technique [0002] In recent years, medical expenses have remained high and increased year by year, and the problem of "difficult and expensive medical treatment" has increasingly become a hot spot of concern from all walks of life. In order to curb the unreasonable rise in medical expenses and improve the level of medical services and medical security, the national level has continuously deepened medical reform, encouraged the society to run hospitals, and liberalized drug pricing; at the same time, local medical insurance agencies are actively exploring new payment methods to To replace the traditional fee-for-service method, the reform of payment-by-disease has the most extensive and profound social impact. In order to explore ways to control the unreasonable growth of medical expenses from the mechanism, and better play the positiv...

AI Technical Summary

Problems solved by technology

[0004] Since the payment by disease type involves all aspects of the entire diagnosis and treatment process, such as medical cost accounting, internal management norms, medical quality control, etc., and also involves many factors such as the rights and interests of the relevant departments of medical services, so in Under the current management system that generally implements payment by item, it will be a very complicated systematic project to implement payment by disease type

[0005] Compared with the international advanced payment methods, the single-disease payment we promote is only the embryonic form of payment by disease type, and there are still many problems and deficiencies. First, the name of "disease" is not uniform and its connotation is not standardized; The coverage of different types of diseases is narrow, and the beneficiary population is limited; the third is that the calculation method of the cost of the disease is arbitrary, lacks scientificity and rationality, and the payment standards for the diseases determined by different regions and different medical institutions are uneven; the fourth is single-disease payment There are many deficiencies in itself, such as the diversity of disease types, differences in personal physique, complexity of medical services, and local economic conditions and price standards, all of which increase the difficulty of implementing single-disease payment; fifth, the management of medical institutions The concept and management level cannot meet the requirements of single-disease payment, which makes the operation of single-disease payment difficult

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