Computerized Classification Study on 680 Clinical Confirmed SARS Patients in Xiao Tang Shan Hospital_Chinese Journal of Evidence-Based Medicine

Authors：

DONG jun ¹ , CAO Xiutang ¹ , LIU Zhimin ¹ , XU Hongmin ¹ , LI Youping ² , SUN Xin ² , WANG Li ² , ZHOU Yachun ³

1. Division of Health Services Quality Management; Chinese PLA General Hospital; Beijing 100853; China2. Chinese Evidence-Based Medicine Center; West China Hospital of Sichuan University; Chengdu 6100413. Xiao Tang Shan Hospital of Chinese PLA; Beijing 102211;

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Keywords：

Xiao Tang Shan Hospital; SARS; Computerized classification

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Objective 　To explore and establish a more precise and reasonable classification method which is suitable for clinical treatment and scientific research of SARS patients.
Methods 　① Establishing a computerized classification method: Analyzing the relationship between variable items on the front page of medical records and severity of disease; Identifying the variable items related to patient’s condition by stepwise identification analysis; Creating a function equation and computerized classification system. ② Comparing and analyzing the difference between computerized and clinical classifications regarding to the general condition of patients, clinical manifestations, laboratorial test results, prognosis, period of hospitalization and medical expenditure, etc.
Results 　① Clinical classification: general cases 642 (94.41%), critical cases 38 (5.59%); Computerized classification: type A 436 (64.12%), type C 237 (34.85%), type D 7 (1.03%), no type B. ② There were statistical significance among groups between two classifications regarding the items of general condition (age, cure rate, mortality and average length of hospitalization), total protein , Alb, BUN and medical expenditure. ③ Comparative analysis of the two classifications: 99.77% of type A cases (general type) by computerized classification were general cases by clinical classification; 97.36% of critical cases by clinical classification were type C amp;D by computerized classification.
Conclusions 　The results are conformity between two classifications and the differences are analogical among thegroups. The statistical difference is significant between general and critical cases with the number of critical cases by computerized classification 6.42 times more than that by clinical classification; Compared with clinical classification, computerized classification has advantages that there is significant difference between the groups while no difference within the groups. With more critical cases and more objective and logic results, the compauterized classification is suitable for study and application in the fields of health service quality management, health economy management and pharmaceutical economics, etc.

Citation： DONG jun,CAO Xiutang,LIU Zhimin,XU Hongmin,LI Youping,SUN Xin,WANG Li,ZHOU Yachun. Computerized Classification Study on 680 Clinical Confirmed SARS Patients in Xiao Tang Shan Hospital. Chinese Journal of Evidence-Based Medicine, 2004, 04(5): 325-332. doi: Copy

1.	［1］Zhu SJ, Dong J. Chief-editor. Hospital administration and information utilizing[ M ]. Beijing: People’ s Military Publisher,2000: 57 - 59.
2.	朱士俊,董军主编.医院管理与信息利用[M].北京:人民军医出版社,2000:57～59.
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10.	［6］Zhang L, Wang WZ. Characteristics and technical points of case by classification[J]. Chinese Journal of Hospital Administration, 2000; 16 (7) :392 - 393.
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12.	［7］Zhang L, Dong J. Application of case by classification in the evaluation of case quality [J ]. Chinese Journal of Hospital Administration,2000; 16 (7): 394 - 398.
13.	张力,董军.病例分型在病例质量评价中的应用[J].中华医院管理杂志,2000;16(7):394～398.
14.	［8］Zhang L, Dong J. Difficulty and countermeasure of case by classificafion[J ]. Chinese Journal of Hospital Administration,2000; 16(7) :408.
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22.	［13］Dong J ,Zhu SJ, Cao XT. Study and application of the realtime control mode of expenses for disease entities quality [ J ].Chinese Health Quality Management, 2001; ( 1 ) :53 - 54.
23.	董军,朱士俊,曹秀堂.病种质量费用实时控制模式研究与应用[J].中国卫生质量管理,2001;(1):53～54.
24.	［14］Dong J, Hu DK, Chen JW. Experimental study on the criteria for the control of expenses for different disease entities[J].Chinese Jourual of Hospital Administration, 2001; 17 ( 9 ): 529-531.
25.	董军,胡德奎,陈剑伟.病种费用控制标准实验研究[J].中华医院管理杂志,2001;17(9):529～531.
26.	［15］Shi BH, Hu DG, Dong J. Analysis and study on the control table of expenses for different disease entities [J ]. Chinese Journal of Hospital Administration, 2001; 17 ( 9 ): 532 - 533.
27.	石冰河,胡德奎,董军.病种费用控制图的分析与研究[J].中华医院管理杂志,2001;17(9):532～533.

1. ［1］Zhu SJ, Dong J. Chief-editor. Hospital administration and information utilizing[ M ]. Beijing: People’ s Military Publisher,2000: 57 - 59.
2. 朱士俊,董军主编.医院管理与信息利用[M].北京:人民军医出版社,2000:57～59.
3. ［2］Fu Z, Ren LZ. Hospital information system construction and application. Beijing: People’ s Military Publisher, 2002.
4. 傅征,任连仲.医院信息系统建设与应用[M].北京:人民军医出版社,2002.
5. ［3］Dong J, Liu ZM, Cao XT, Li YP, Sun Xin, Zhou YC, Zhang YL,Xie LX, Xu WY, Wang HT, Xu HM. Construction of SARS Information System in Xiao Tang Shan Hospital [ J ].Chinese Journal of Evidence-Based Medicine. 2004; 4 ( 3 ): 181- 186.
6. 董军,刘志敏,曹秀堂,李幼平,孙鑫,周亚春,张雁灵,解立新,徐武夷,王海涛,许红民.小汤山医院SARS诊疗信息数据库建设[J].中国循证医学杂志,2004;4(3):181～186.
7. ［4］Dong J, Cao XT, Sun X, Zhou YC, Chen HW,Yuan ZJ,Liu ZM,Wang HT,Xu HM. Medical expenditure and influential factor analysis of 680 SARS cases[J]. Chinese Journal of Evidence-Based Medicine, 2003; 3(3):222-230.
8. 董军,曹秀堂,孙鑫,周亚春,陈杭薇,袁志军,刘志敏,王海涛,许红民.680例SAKS临床确诊患者医疗费用和影响因素分析[J].中国循证医学杂志,2003,3(3):222～230.
9. ［5］Zhang L, Dong J. The principle and methodology of case by classification [ J ]. Hospital Administration Journal of Chinese People’ s Liberation Army, 2000 ;7 (2): 101 - 103张力,董军.病例分型的原则与方法[J].解放军医院管理杂志,2000;7(2):101～103.
10. ［6］Zhang L, Wang WZ. Characteristics and technical points of case by classification[J]. Chinese Journal of Hospital Administration, 2000; 16 (7) :392 - 393.
11. 张力,王文中.病例分型的特点和技术要点[J].中华医院管理杂志,2000;16(7):392～393.
12. ［7］Zhang L, Dong J. Application of case by classification in the evaluation of case quality [J ]. Chinese Journal of Hospital Administration,2000; 16 (7): 394 - 398.
13. 张力,董军.病例分型在病例质量评价中的应用[J].中华医院管理杂志,2000;16(7):394～398.
14. ［8］Zhang L, Dong J. Difficulty and countermeasure of case by classificafion[J ]. Chinese Journal of Hospital Administration,2000; 16(7) :408.
15. 张力,董军.病例分型的难点和对策[J].中华医院管理杂志,2000;16(7):408.
16. ［9］Hugh SA, Leonie M. Casemix for all[ M ]. Redcliffe Medical Press, 1999. 5 - 16.
17. ［10］Forgione DA, D’ Annunzio CM. The use of DRGs in health care payment systems around the world[J ], J health Care Finance ,1999; 26:66 -78.
18. ［11］Huang HY. Development of DRGs in U. S. A[J]. Chinese Journal of Hospital Administration, 1992 ;7(8): 433.
19. 黄慧英.诊断相关分类法DRGs在美国的发展[J].中华医院管理杂志,1992;7(8):433.
20. ［12］Ma J. Study on the new mode of DRGs system[J]. Chinese Hospital management, 1994; 14(9) :10.
21. 马俊.DRGs系统新模式的研究[J].中国医院管理,1994;14(9):10.
22. ［13］Dong J ,Zhu SJ, Cao XT. Study and application of the realtime control mode of expenses for disease entities quality [ J ].Chinese Health Quality Management, 2001; ( 1 ) :53 - 54.
23. 董军,朱士俊,曹秀堂.病种质量费用实时控制模式研究与应用[J].中国卫生质量管理,2001;(1):53～54.
24. ［14］Dong J, Hu DK, Chen JW. Experimental study on the criteria for the control of expenses for different disease entities[J].Chinese Jourual of Hospital Administration, 2001; 17 ( 9 ): 529-531.
25. 董军,胡德奎,陈剑伟.病种费用控制标准实验研究[J].中华医院管理杂志,2001;17(9):529～531.
26. ［15］Shi BH, Hu DG, Dong J. Analysis and study on the control table of expenses for different disease entities [J ]. Chinese Journal of Hospital Administration, 2001; 17 ( 9 ): 532 - 533.
27. 石冰河,胡德奎,董军.病种费用控制图的分析与研究[J].中华医院管理杂志,2001;17(9):532～533.

Chinese Journal of Evidence-Based Medicine

Computerized Classification Study on 680 Clinical Confirmed SARS Patients in Xiao Tang Shan Hospital

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