基于PDCA循环的全面质量管理在提高医保病案编码准确率中的作用分析

目的:分析实施基于PDCA循环全面质量管理对于提升医保病案变准确率的作用。方法:共选择2022年1月-12月之间需要编码的200分医保病案作为研究内容,按照常规质量管理、基于PDCA循环的全面质量管理,分为对照组和观察组。分析和对比管理效果、编码错误原因、管理质量评价情况。并且选择了共30名编码人员参与满意度调查,明确其对于不同方法的认可度。结果:与对照组相比,观察组的病案质量合格率、编码准确率更高,返修率更低(P<0.05),且管理质量评价更高(P<0.05)。同时,共五种原因为编码错误的主要原因,其中观察组的错误率低于对照组(P<0.05)。调查满意度情况,观察组编码人员的满意度更高(P<0.05)。结论:基于PDCA循环实施的全面质量管理有助于提升病案合格率、编码准确率,降低返修率和错误率,提升管理质量,获得相关人员的高度认可和满意。

Objective:To analyze the effect of PDCA-based total quality management(TQM)on improving the accuracy of medical records.Methods:A total of 200 medical insurance records that need to be coded from January to December 2022 were selected as the research content,and were divided into control group and observation group according to routine quality management and total quality management based on PDCA cycle.Analysis and comparison of management effect,coding error causes,management quality evaluation.A total of 30 coders were selected to participate in the satisfaction survey to clarify their recognition of different methods.Results:Compared with the control group,the quality qualification rate and coding accuracy rate of medical records in the observation group were higher,the repair rate was lower(P<0.05),and the management quality evaluation was higher(P<0.05).At the same time,a total of five reasons were the main causes of coding errors,and the error rate of the observation group was lower than that of the control group(P<0.05).The satisfaction of coders in the observation group was higher(P<0.05).Conclusion:The implementation of total quality management based on PDCA cycle is helpful to improve the qualification rate of medical records,coding accuracy,reduce the repair rate and error rate,improve the management quality,and obtain high recognition and satisfaction from relevant personnel.