Muranaga F, Kumamoto I, Uto Y
Department of Medical Informatics, Kagoshima University Hospital, Sakuragaoka 8-35-1, Kagoshima City 890-8520, Japan.
Methods Inf Med. 2007;46(6):679-85.
To develop a data warehouse system for cost analysis, based on the categories of the diagnosis procedure combination (DPC) system, in which medical costs were estimated by DPC category and factors influencing the balance between costs and fees.
We developed a data warehouse system for cost analysis using data from the hospital central data warehouse system. The balance data of patients who were discharged from Kagoshima University Hospital from April 2003 to March 2005 were determined in terms of medical procedure, cost per day and patient admission in order to conduct a drill-down analysis. To evaluate this system, we analyzed cash flow by DPC category of patients who were categorized as having malignant tumors and whose DPC category was reevaluated in 2004.
The percentages of medical expenses were highest in patients with acute leukemia, non-Hodgkin's lymphoma, and particularly in patients with malignant tumors of the liver and intrahepatic bile duct. Imaging tests degraded the percentages of medical expenses in Kagoshima University Hospital.
These results suggested that cost analysis by patient is important for hospital administration in the inclusive evaluation system using a case-mix index such as DPC.
基于诊断程序组合（DPC）系统的类别开发一个用于成本分析的数据仓库系统，其中医疗成本按DPC类别以及影响成本与费用平衡的因素进行估算。
我们利用医院中央数据仓库系统中的数据开发了一个用于成本分析的数据仓库系统。为了进行深入分析，确定了2003年4月至2005年3月从鹿儿岛大学医院出院患者的医疗程序、每日成本和患者住院情况的平衡数据。为评估该系统，我们按DPC类别分析了被归类为患有恶性肿瘤且其DPC类别在2004年重新评估的患者的现金流。
急性白血病、非霍奇金淋巴瘤患者，尤其是肝和肝内胆管恶性肿瘤患者的医疗费用百分比最高。在鹿儿岛大学医院，影像检查降低了医疗费用的百分比。
这些结果表明，在使用如DPC这样的病例组合指数的综合评估系统中，按患者进行成本分析对医院管理很重要。
