Fundamental data of sufferers with UL
A complete of 3087 eligible UL instances had been enrolled on this examine, with a mean age of 43.03 years outdated and a median age of 44.00 years outdated. The age distribution confirmed that 29.58% of sufferers had been aged ≤ 39 years, 53.97% had been aged 40–49 years, and 16.46% had been aged ≥ 50 years. The overwhelming majority of sufferers had been of Han ethnicity (98.06%) and married (93.85%). Roughly 96.7% of sufferers had been coated by Medicare, whereas 3.3% had been self-paying. The common LOS was 6.66 days, and 62% of all had a LOS ≤ 7 Days. The most typical surgical procedure sort was hysteroscopic surgical procedure (42.47%), adopted by high-intensity targeted ultrasound (26.17%) and common operation (22.55%). The common complete hospitalization value was 22,436.11 yuan and the median was 22,825.74 yuan. Detailed demographic traits and scientific options had been introduced in (Desk 1).
Composition of hospitalization prices
With a purpose to remove the impact of inflation, the 2021 hospitalization prices for sufferers with UL had been used because the baseline, and the hospitalization prices for sufferers with UL had been additionally adjusted earlier than and after the DRG fee based on the patron value index for healthcare residents in Chongqing, as revealed by the nationwide bureau of statistics. The very best proportion of the entire hospitalization value was therapy value (29.46%), adopted by diagnostic value (28.98%), consumable value (26.01%), medication value (9.00%), service value (5.92%) and many others. (Desk 2). The price of therapy, analysis and consumables accounted for 84.45% of the entire value.
Univariate evaluation of the influencing components on hospitalized prices
The dependent variable for this examine was the hospitalization value for UL. The unbiased variables included age, nationality, marital standing, sort of medical insurance coverage, admission methodology, admission situation, medical recommendation discharge, 31-day readmission schedule, Therapeutic results, LOS, surgical procedure sort, and CCs. The Mann-Whitney U check or Kruskal-Wallis H check had been carried out the evaluation. The outcomes turned out that, besides nationality, all different components had a major influence on the hospitalization prices in sufferers with UL (Desk 1).
A number of regression evaluation of the influencing components on hospitalized prices
For the reason that hospitalization prices for UL didn’t comply with a traditional distribution, we employed binary logistic regression evaluation for logistic regression evaluation. Sufferers had been stratified into two classes primarily based on the median value of hospitalization, which was decided to be 22,436.11 yuan. This categorization resulted within the identification of a high-cost group (prices greater than 22,436.11 yuan, coded as 1) and a low-cost group (prices lower than 22,436.11 yuan, coded as 0). A binary logistic regression mannequin was constructed with the hospitalization prices group for sufferers with UL because the dependent variable and the outcomes of univariate evaluation as unbiased variables. For unordered multinomial categorical variables, dummy variables had been created with the primary class at every issue degree serving because the reference. The variance inflation issue of all predictors used within the mannequin was examined to be lower than 3 indicating that there isn’t a multicollinearity among the many unbiased variables. The findings revealed that age, surgical procedure sort, LOS, and CCs considerably influenced the hospitalization prices in UL sufferers (Desk 3).
DRG grouping: a call tree mannequin to assemble the case mixture and the hospitalization value of every group
The hospitalization prices was used because the dependent variable, and the numerous components together with age, LOS, surgical procedure sort, and CCs had been used because the unbiased variables, which had been included within the choice tree mannequin. The parameters used on this examine are as follows:11,12 the utmost depth of the choice tree mannequin is 3, the minimal pattern measurement of the father or mother node is 100, the minimal pattern measurement of the kid node is 50, and the importance degree of the cut up node is α = 0.05. A complete of 10 teams had been recognized (Fig. 1). After grouping, the Kruskal-Wallis non-parametric check was used to check the associated fee variations between teams. The outcomes confirmed that the associated fee distribution of the ten teams weren’t similar (Chi-square worth was 2152.551, P < 0.05), indicating heterogeneity among the many completely different DRG teams and statistically vital variations.
To reinforce the comprehensibility of the price of every DRG group, we included the unique worth of hospitalization prices within the evaluation. As hospitalization prices are irregular distribution, we used the median as the usual value of medical useful resource consumption for UL instances. The calculated RIV worth was 0.68, indicating vital heterogeneity between teams and vital classification. The CV for hospitalization prices ranged from 0.08 to 0.43, indicating minimal variation and affordable grouping outcome. To ascertain value management measures, the warning value was set at 75(th) quantile of the inpatient value for every DRG group, whereas the higher restrict was set at 75(th) quantile plus 1.5 instances the interquartile distance (P75 + 1.5Q). The outcomes revealed that 40 instances (1.30% of the entire) exceeded the higher restrict in every DRG group (Desk 4).
Determination tree diagram of influencing components of hospitalization prices of uterine leiomyoma.
