Prediction of Diagnosis-Related Groups for Appendectomy Patients Using C4.5 and Neural Network

Healthcare (Basel). 2023 May 30;11(11):1598. doi: 10.3390/healthcare11111598.

Abstract

Due to the increasing cost of health insurance, for decades, many countries have endeavored to constrain the cost of insurance by utilizing a DRG payment system. In most cases, under the DRG payment system, hospitals cannot exactly know which DRG code inpatients are until they are discharged. This paper focuses on the prediction of what DRG code appendectomy patients will be classified with when they are admitted to hospital. We utilize two models (or classifiers) constructed using the C4.5 algorithm and back-propagation neural network (BPN). We conducted experiments with the data collected from two hospitals. The results show that the accuracies of these two classification models can be up to 97.84% and 98.70%, respectively. According to the predicted DRG code, hospitals can effectively arrange medical resources with certainty, then, in turn, improve the quality of the medical care patients receive.

Keywords: C4.5; DRG; appendectomy; back-propagation neural network; diagnosis-related groups.

Grants and funding

This research was funded by Grant MOST104-2218-E-194-007, National Science Foundation, Taiwan.