影響詳嚓P係群因素研究以胃癌為例.docVIP

Using Knowledge Discovery to Development a Procedure for DRGs By Wen-Hsiang Wu Department of Healthcare Management,Yuanpei University of Science and Technology,Hsinchu, Taiwan E-mail: HYPERLINK mailto:wenhsiang_wu@.twwenhsiang_wu@.tw Shuenn-Ren Cheng Department of Busin ess Cheng Shiu UniversityKaohsiung, TaiwanE-mail:HYPERLINK mailto:tommy@.twtommy@.tw Juei-Chao Chen Gradate Institute of Applied Statistics, Fu Jen Catholic University,Taipei, Taiwan E-mail: statl()HYPERLINK mailto:14@.tw14@.tw Don Jyh-Fu Jeng Graduate School of Information, Production and SystemsWaseda UniversityKitakyushu, Japan E-mail: HYPERLINK mailto:don_jeng@don_jeng@ Mei-Roung Chen Gradate Institute of Applied Statistics, Fu Jen Catholic University,Taipei, Taiwan E-mail: may()611 @.tw Abstract The purpose of this study is to develop a diagnostic-related groups (DRGs) system with better forecasting ability in medical expenses through the knowledge discovery process and classification and regression tree (CRT) in data mining. United States uses the Centers for Medicare and Medicaid DRGs (CMS-DRGs) as a reimbursement basis for medical expenses, but the most controversial is its insufficient ability in medical expenses forecasting. In this research, the disease category of ICD-9 CM is used in replacing the major and secondary dianositic category of CMS-DRGs, and by adding the stage of disease to solve the insufficient ability in medical expenses forecasting that causes by the CMS-DRGs only take the complications and comorbidities into consideration. Furthermore, with the classification of procedures of ICD-9 CM, the cases with similar medical expensis are mixed for improving the DRGs5 forecasting ability. The healthcare administrator can benefit form this research by modifying the DRGs system to avoid the opportunistic behavior from medical providers- On the other hand, the medical providers can benefit from this research by understand the cost of different disease category and different o