Evaluation of the Use of a Novel Intelligent Diagnosis and Cost Control System on Pediatric Bronchopneumonia Outcomes: Retrospective Cohort Study.

Background: Health care systems face challenges of inconsistent quality, inefficiency, and rising costs. Fragmented applications of clinical decision support systems (CDSSs), clinical pathways (CPs), and diagnosis-related group (DRG) payment systems have limited their synergistic potential. Objective: This study proposed a CDSS-CP-DRG closed-loop model enabled by digital health technologies; specifically, the CDSS optimized CP execution through real-time data, the CP standardized workflows to support DRG cost control, and DRG payment pressures drove iterative improvements in both technology and processes. This research aimed to validate the model's effectiveness in clinical efficacy, cost control, and standardized diagnosis and treatment of bronchopneumonia in children and provide evidence for value-based health care transformation. Methods: A total of 4543 children with bronchopneumonia were selected and divided into the experimental or control group based on whether the intelligent diagnosis and cost control system was used in the diagnostic process. Chi-square test, 1-way analysis of variance, paired t test, multiple regression analysis, and other mathematical statistical methods were used to verify the difference between the outcomes of the two groups of patients. Results: This study demonstrated comparably high cure rates in both groups (P>.05). However, the experimental group exhibited a 0.4-day reduction in average length of stay, 12.3% lower total hospitalization costs, RMB 135.3 (US $19) higher medical insurance reimbursement surplus, and a reduction of 0.16 defined daily doses of antibiotic use intensity versus the control group (P<.05 for all significant differences). Conclusions: The novel intelligent diagnosis and cost control system demonstrated significant improvement in clinical effect, cost control, and standardized treatment for pediatric bronchopneumonia, but the CP for pediatric pneumonia requiring intensive care still needs further attention and adjustment.