CCSBD: A Cost Control System Based on Blockchain and DRG Mechanism

Abstract

Diagnosis Related Group (DRG) allows patients to be grouped according to the initial diagnosis and to be prepaid within the group. Actual costs in follow-up treatment cannot exceed the prepaid value, achieving the purpose of medical cost control. Three problems exist in the process. First, some treatment operations are highly overlapping and therefore cannot be accurately classified. Second, classification data cannot be credibly shared across hospitals. Third problem is the historical payment path required to predict costs cannot be fully traced. To address these problems, we design a Cost Control System Based on Blockchain and DRG Mechanism (CCSBD). We proposes a fusion classification model to realize the contribution assessment of the important feature factors, leading to accurate classification. In order to ensure the security and consistency of shared information, We establish a hyper-ledger blockchain architecture for secure sharing of medical data. Through smart contract, the architecture realizes dynamic consensus endorsement of data and cross-chain cross-authentication of departmental attributes. We realize value data screening and clinical path tracking through logical chain code to generate reasonable cost metrics to predict expenses, and implement CCSBD on the Fabric consortium-chain platform. Through comparative analysis with three single classification models, we prove that CCSBD improves classification accuracy by 7%. Furthermore, the security and efficiency of the shared structure are demonstrated by smart contract latency tests and consistency attack tests.