Monitoring mechanism for high group behavior based on the big data diagnosis-intervention packet
10.3760/cma.j.cn111325-20201009-02015
- VernacularTitle:基于大数据的病种分值付费组别高套发现机制研究
- Author:
Xin CUI
1
;
Hua XIE
;
Yujia YANG
;
Jianwei XUAN
;
Li LI
;
Senran WANG
;
Su XU
Author Information
1. 上海市卫生健康信息中心 200040
- Keywords:
Big data;
Diagnosis-intervention packet;
Pursuing a higher score group;
Discovery mechanism
- From:
Chinese Journal of Hospital Administration
2021;37(3):196-198
- CountryChina
- Language:Chinese
-
Abstract:
One of the challenges to diagnosis-intervention packet is how to detect and avoid the institutional behavior of pursuing a higher score group. Based on the analysis method of big data, the authors analyzed the objective distribution characteristics of the treatment methods corresponding to a diagnosis, and compared the distribution of diseases with high and low scores in the region to find out the selection trend of treatment methods for the same diagnosis in various hospitals. Combined with hospital positioning, the authors found out whether there was a tendency of pursuing a higher score group. Scientific support will be provided for the reasonable payment of medical insurance expenses and the development planning of hospitals.
