摘要
目的在现有手术分级系统基础上,研究一种新的手术分级评价方法,以跨专业量化评价手术难度和风险,将高难度手术进一步细化分组。方法以2017年ICD-9-CM-3国家临床版为基准编码,使用劳动价值点数和风险点数,参考《中国医疗服务操作项目分类与编码》为手术和操作项目定量赋值,赋值后进行数学分析,对分析结果与医院的实际数据对比校验分析,选择work RVU和PLI RVU二维数组作为统计量,使用K-means聚类算法,产生新的分级。结果使用新的分级算法验证历史数据,与预期吻合度较高。结论可以使用劳动价值和风险点数两维数组,使用K-means聚类方法,产生统一编码、定量的可以跨专业比较的手术难度评价系统。
Objective Based on the present surgical grading system,a new surgical grading system was established to evaluate interdisciplinary surgical difficulty and risk,to further refine group for high-grading surgery. Methods According to 2017 national clinical version of ICD-9-CM-3 code,work RVU and PLI RVU value of RBRVS were assigned to every sur. gery and procedure item,referred by Chinese Classification of Health Interventions. After mathematical analysis,the re. sult of the analysis was compared with the actual data of hospital for check analysis. The two-dimensional array of work RVU and PLI RVU value were selected as the statistics,and the K-means clustering algorithm was applied to generate a new grading. Results The new grading algorithm was used to verify the historical data,which is consistent with the expec. tation. Conclusion Work RVU and PLI RVU value can be used to form a two dimensional array, and through doing Kmeans cluster analysis,a unified coded surgical grading system can be established,which can quantitatively evaluate the interdisciplinary operation difficulty.
作者
王志刚
鲁冰
储进
张娴静
蔡静
王爱荣
WANGZhi-gang;LU Bing;CHU Jin(Shanghai Palline Data Technology Co.,Ltd,Shanghai,200120,China)
出处
《中国医院管理》
北大核心
2019年第4期12-14,17,共4页
Chinese Hospital Management
基金
上海申康医院发展中心管理研究项目(2018SKMR-24)
