多院区病案号分派管理对病案归档上架的影响

The Effect of Medical Record Number Assignment in Multiple-sections of Hospitals on the Filing Error Ratio of Medical Records

目的探讨多院区分派病案号管理的最佳方案,最大程度减少归档上架的错误率。方法多院区病案管理和保存,采用两种分派病案号的方案。方案一,分院区派发病案号(以字母标示区别);方案二,以医院为整体,不论院区,统一派发病案号。依照上述两种方案,2011年第一季度的出院病案均以方案一分派病案号;2013年第一季度的出院病案以方案二分派病案号,分别计算当季上架错误率,以卡方检验检测两者是否具有差异性。结果 2011年第一季度与2013年第一季度上架错误率比较,2011年第一季度上架错误例数42例(占0.75%);2013年第一季度上架错误例数351例(占3.31%),χ~2=100.9542,P<2.2×10^(-16),具有明显差异性(P<0.05)。结论分院区派发病案号可减少上架错误率,利于分散院区库房保存。根据目前实际情况,可采用病案外包式管理与病案数字化管理相结合方式,逐步过渡到完全无纸化的电子病案。这也是解决多院区病案号分派问题的方法之一。

Objectives To explore the best solution of medical record number assignment on multiple-sections of hospital and reduce filing error ratio to the largest extent. Methods Two medical record numbers assignments solutions were put forward for the management and storage of medical records in multiple-sections of hospital.Method 1： Medical record number was assigned based on separate area（signalized by letter）; Method 2： Medical record number was assigned by sequence as a whole serial system（no matter what section was）.Depending on these two approaches, medical record numbers of January to March in 2011 were while medical record numbers between January and March in 2013 were assigned by method 2. Compared the error probability of filing of two ways, then investigated whether there existing significance by X^2-test. Results Compared the error ratio of two methods, there were 42 wrong filing cases（0.75%） in the first quarter of 2011, while 351 wrong filing cases（3.31%） in the first quarter of 2013,X^2=100.9542,P2.2×10^-16,which had significant difference（P〈0.05）. Conclusions To distribute medical record number in multiple-sections of hospital could reduce filing error rates, which was good for dispersing the storage of medical records. According to the current situation, we could adopt the combination mode of medical records outsourcing and digitization medical records management,and transfer to paperless electronic medical records gradually, this was also one of the methods to solve the medical record numbers distribution problems of multiple-sections of hospital.