摘要
通过挖掘DRGs超标费用的关联规则,可提高医疗保险费用的科学管控水平。基于3σ准则,从DRGs的审核报销记录中筛选异常数据,即超标费用数据;提取超标费用病例若干属性,在数据预处理后,利用Apriori关联规则挖掘与超标费用相关的属性。从审核报销记录中,挖掘出了超标费用病例;基于超标费用的病例,挖掘出了与超标费用相关的属性。基于关联规则的DRGs超标费用分析,得出了较合理的关联规则,可以指导医疗费用管控的实践,也可为相关研究提供经验。
By exploring the association rules of DRGs excessive expenses,the scientific management and control of medical insurance can be improved.Based on 3σcriterion,outlier data is screened from DRGs’audit and reimbursement records,that is,excessive expense data.Several attributes of excessive expense cases are extracted.After data preprocessing,Apriori association rules are used to explore the attributes related to excessive expenses.From the audit reimbursement records,the cases of excessive expenses are explored;based on the cases of excessive expenses,the attributes related to excessive expenses are explored.The conclusion is that,by analysis of DRGs excessive expenses based on association rules,the paper can provide more reasonable guidance for the practice of medical expenses management and control,it can also provide experience for related researches.
作者
王健
毋丽丽
赵青杉
曹伟
申爱华
WANG Jian;WU Lili;ZHAO Qingshan;CAO Weia;SHEN Aihua(Department of Computer Science,Xinzhou Normal University,Xinzhou 034000,China;Medical Insurance Department,Shuigang General Hospital,Liupanshui 553000,China;Information Centre,Shuigang General Hospital,Liupanshui 553000,China)
出处
《太原学院学报（自然科学版）》
2022年第3期60-64,共5页
Journal of TaiYuan University:Natural Science Edition
