【摘要】 目的：分析以疾病诊断相关分组（DRG）为基础的营养不良住院病人费用结构及变异系数，为DRG进一步推广应用提供参考依据。方法：收集宁夏回族自治区人民医院2023年3月至2023年8月期间的住院病人的DRG住院相关信息资料，采用人工智能营养不良诊断系统筛选营养不良病人，描述营养不良病人住院费用的构成及分析DRG分组下各项费用变异系数，采用多因素回归分析筛选影响病人住院费用的相关因素。结果：营养不良住院病人平均年龄（68.12±16.43）岁，平均住院天数（14.55±8.47）d，平均住院费用（32 128.89±35 345.61）元，在同一个DRG组中，营养不良组病人各项费用的变异系数均低于非营养不良组病人（P<0.05），即营养不良组病人单独评价时组内各项费用的同质性更高。影响病人住院总费用因素依次为：住院天数（P=0.001）、营养监测费（P=0.020）、慢病种类数量（P=0.003）和卡诺夫斯基功能状态（KPS）评分（P=0.038），住院费用与住院天数和营养指标检查费用呈正相关，与慢病种类数量和KPS评分呈负相关。结论：营养不良对健康、医疗花费、住院时间（LOS）和疾病严重程度(SOI)影响显著，通过DRG分组技术有望推动营养诊治流程标准化和细化不同程度营养不良诊断分组，可减少DRG组内差异，以便更精准高效的分配医疗资源，为各地进一步推广DRG付费改革提供参考。更多还原

【Abstract】 Objectives: The aim is to analyze the cost structure and coefficient of variation for hospitalized patients with malnutrition based on Diagnosis-Related Groups(DRG), providing a reference for the further application and promotion of DRG. Method: Data were collected from patients admitted to Ningxia Hui Autonomous Region People’s Hospital between March 2023 and August 2023. A diagnostic system based on artificial intelligence was used to identify malnourished patients. The composition of hospitalization costs for these individuals was described and analyzed, as was the coefficient of variation for various costs within DRG groupings. A multivariate regression analysis was conducted to identify the factors that influence patient hospitalization costs. Results: The average age of hospitalized patients with malnutrition was(68.12 ± 16.43) years, with an average length of stay of(14.55 ± 8.47) days, with an average hospitalization cost of(32 128.89 ± 35 345.61) yuan. Among patients within the same DRG group, the coefficient of variation for various costs was found to be lower in the malnutrition group than in the normal group. This suggests that when assessed individually, the malnutrition group exhibited a higher degree of homogeneity in their cost structures. The factors influencing total hospitalization costs were found to be: length of hospital stay(P = 0.001), nutritional monitoring fees(P = 0.020), number of chronic diseases(P = 0.003), and Karnofsky Performance Status(KPS) score(P = 0.038). Hospitalization costs were positively correlated with both length of stay and nutritional assessment fees, but negatively correlated with the number of chronic diseases and KPS scores. Conclusions: Malnutrition has a profound impact on health outcomes, medical expenses, length of hospital stay, and disease severity. The implementation of the DRG system aims to standardize and improve the nutritional diagnosis and treatment process by categorizing different stages of malnutrition. This approach can minimize variations within DRG groups, making it easier to allocate medical resources more precisely and efficiently. Furthermore, it is a valuable reference tool for promoting DRG payment reform in different regions.更多还原