發(fā)布時(shí)間：2018-01-15 06:26

  本文關(guān)鍵詞：面向DRG的集成化醫(yī)療服務(wù)成本管理模式與方法研究　出處：《天津大學(xué)》2013年博士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 診斷相關(guān)組 醫(yī)療服務(wù) 集成化管理 成本預(yù)測(cè) 成本控制

【摘要】：本文從集成化管理的角度研究面向DRG的醫(yī)療服務(wù)成本管理，針對(duì)醫(yī)療服務(wù)成本管理研究現(xiàn)狀和我國(guó)醫(yī)院推行DRG存在的實(shí)際成本管理問(wèn)題，應(yīng)用集成化、系統(tǒng)化的思想，，研究了面向DRG的集成化醫(yī)療服務(wù)成本管理的基本理論和管理模式，并針對(duì)病種成本預(yù)測(cè)和控制的特點(diǎn)及存在的問(wèn)題進(jìn)行了深入研究，主要研究成果如下： 第一，對(duì)當(dāng)前國(guó)內(nèi)外關(guān)于醫(yī)療服務(wù)成本管理的研究文獻(xiàn)進(jìn)行了分類、分析和評(píng)述，進(jìn)而論述了目前醫(yī)療服務(wù)成本管理的主要研究方向，并在此基礎(chǔ)上提出了本文所要研究的主要問(wèn)題。 第二，分析了DRG對(duì)醫(yī)療服務(wù)成本管理的影響，研究并分析了面向DRG的集成化醫(yī)療服務(wù)成本管理的體系結(jié)構(gòu)、特征，構(gòu)建了實(shí)施面向DRG的集成化醫(yī)療服務(wù)成本管理的理論框架，然后，在此基礎(chǔ)上，提出并構(gòu)建了面向DRG的集成化醫(yī)療服務(wù)成本管理模式的框架模型，并對(duì)系統(tǒng)框架的構(gòu)成和特征進(jìn)行了詳細(xì)的說(shuō)明。 第三，根據(jù)病種成本管理的需要，建立病種成本數(shù)據(jù)倉(cāng)庫(kù)模型。然后，基于類物料清單（GBOM）構(gòu)建了單病種及病種系列成本影響因素表達(dá)模型，并進(jìn)行數(shù)學(xué)描述。最后，運(yùn)用粗糙集理論構(gòu)建了病種成本影響因素約簡(jiǎn)模型，并進(jìn)行了應(yīng)用研究。 第四，針對(duì)病種成本預(yù)測(cè)方法展開(kāi)研究。首先，提出了基于知識(shí)發(fā)現(xiàn)（KDD）的病種成本預(yù)測(cè)系統(tǒng)框架。然后，重點(diǎn)研究了基于SVM的單病種成本預(yù)測(cè)方法和基于PSO優(yōu)化SVM的DRG病種系列成本預(yù)測(cè)方法。 第五，針對(duì)病種成本控制方法展開(kāi)研究。首先，將預(yù)測(cè)控制的思想引入病種成本控制，提出了病種成本預(yù)測(cè)控制的模式。然后，將EWMA控制圖和LSSVM引入病種成本控制，建立了基于EWMA控制圖和LSSVM的病種成本預(yù)測(cè)控制模型和基于GA優(yōu)化LSSVM的病種成本差異識(shí)別模型。 第六，面向成本的醫(yī)療服務(wù)運(yùn)營(yíng)優(yōu)化策略。在分析我國(guó)醫(yī)療服務(wù)運(yùn)營(yíng)存在的問(wèn)題的基礎(chǔ)上，從醫(yī)院設(shè)施和人員配置的角度運(yùn)用排隊(duì)論、系統(tǒng)仿真以及整數(shù)規(guī)劃等方法研究降低病種成本的策略。
[Abstract]:This paper studies the DRG oriented medical service cost management from the perspective of integrated management. Aiming at the current research situation of medical service cost management and the actual cost management problems existing in the implementation of DRG in Chinese hospitals, the application of integration. Based on the systematic idea, the basic theory and management model of integrated medical service cost management for DRG are studied, and the characteristics and problems of disease cost prediction and control are deeply studied. The main findings are as follows: First, the research literature on medical service cost management at home and abroad has been classified, analyzed and commented, and then discussed the main research direction of medical service cost management. On this basis, the main problems to be studied in this paper are put forward. Secondly, this paper analyzes the impact of DRG on the cost management of medical services, studies and analyzes the architecture and characteristics of integrated cost management of medical services for DRG. The theoretical framework of implementing integrated medical service cost management for DRG is constructed, and then, on this basis, the framework model of integrated medical service cost management model oriented to DRG is proposed and constructed. The structure and characteristics of the system framework are explained in detail. Thirdly, according to the need of disease cost management, the data warehouse model of disease cost is established. Then, based on the GBOM, the expression model of single disease and disease series cost influencing factors is constructed. Finally, using rough set theory to construct the reduction model of the factors affecting the disease cost, and carry on the application research. In 4th, the cost forecasting method of disease species was studied. Firstly, the framework of disease cost forecasting system based on KDD was proposed. The cost forecasting method of single disease based on SVM and series cost forecasting method of DRG disease based on PSO optimization SVM were studied. In 5th, the method of disease cost control was studied. Firstly, the idea of predictive control was introduced into disease cost control, and the model of disease cost predictive control was put forward. EWMA control chart and LSSVM were introduced into disease cost control. The predictive control model of disease cost based on EWMA control chart and LSSVM and the differential identification model of disease cost based on GA optimized LSSVM were established. 6th, a cost-oriented optimization strategy for medical service operation. Based on the analysis of the problems existing in the operation of medical services in China, the queuing theory is applied from the perspective of hospital facilities and staffing. System simulation and integer programming are used to study the strategies to reduce the cost of disease.
【學(xué)位授予單位】：天津大學(xué)
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2013
【分類號(hào)】：R197.32

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 趙水長(zhǎng);;醫(yī)院成本核算與成本控制方法分析[J];財(cái)會(huì)月刊;2011年08期

2 張培林;朱小玲;朱秀芳;劉憲;路曉欽;;平衡計(jì)分卡指標(biāo)體系在醫(yī)院成本控制中的理論與實(shí)踐研究[J];重慶醫(yī)學(xué);2009年01期

3 王慶;;基于粗集理論的工作分析[J];系統(tǒng)工程;2007年05期

4 李惠;劉子先;門(mén)峰;;基于臨床路徑與CBR的單病種成本預(yù)測(cè)研究[J];工業(yè)工程與管理;2010年03期

5 于樺，胡平玲;質(zhì)量控制圖在醫(yī)院質(zhì)量管理方面的應(yīng)用[J];第一軍醫(yī)大學(xué)學(xué)報(bào);1995年02期

6 朱霖;葉宜德;吳曉紅;;安徽省基層醫(yī)藥衛(wèi)生體制綜合改革中的政府職責(zé)及其實(shí)現(xiàn)形式探討[J];華東經(jīng)濟(jì)管理;2010年10期

7 尉詢楷,李應(yīng)紅,王碩,路建明,汪誠(chéng);基于支持向量機(jī)的航空發(fā)動(dòng)機(jī)滑油監(jiān)控分析[J];航空動(dòng)力學(xué)報(bào);2004年03期

8 樂(lè)清洪 ,李建文 ,安翔 ,朱名銓;控制圖異常模式參數(shù)估計(jì)的神經(jīng)網(wǎng)絡(luò)方法[J];航空制造技術(shù);2002年04期

9 李秀云,汪暉華;影響護(hù)理排班的相關(guān)因素及對(duì)策[J];現(xiàn)代護(hù)理;2001年06期

10 徐德寶;控制在護(hù)士排班中的應(yīng)用[J];護(hù)理學(xué)雜志;2002年08期

相關(guān)博士學(xué)位論文 前1條

1 陶紅兵;基于單病種管理的醫(yī)院住院病人費(fèi)用控制的管理策略研究[D];華中科技大學(xué);2008年

本文編號(hào)：1427187