应用ICD-10编码辅助分析诊断质量

Auxiliary Analysis of Diagnosis Quality by ICD-10 Coding

目的借助ICD-10编码辅助分析医院诊断质量。方法通过秩和比法和帕累托法分析宁夏某三甲医院2009—2011年住院疾病构成,计算主要疾病类别的入出院诊断ICD-10编码符合率及三种不符合率,通过卡方检验分析上述指标在不同年份的差异。结果疾病谱主要因素中八大类疾病的入出院诊断ICD-10编码符合率均逐年降低;八大类的类目外不符合率均逐年增高;七大类的类目下亚目上不符合率逐年增高;消化系统疾病的亚目下不符合率逐年增高,而肿瘤的亚目下不符合率逐年降低。差异均具有统计学意义。结论分析入出院诊断ICD-10编码符合情况,可以反映诊断准确性的变化,为评估诊断质量提供有用信息。

Objective To analyze diagnosis quality in the respect of ICD-10 Coding. Methods The disease composition of a 3 A hospital in Ningxia province in 2009,2010 and 2011 was analyzed by rank-sum ratio and Pareto analytical method. The admission-and-discharge ICD-10 coding accordance rate and three kinds of disaccord rates of 8 major categories were calculated. The rates＇ differences between years were analyzed by chi-square test. Results From 2009 to 2011,the ICD-10 coding accordance of all 8 categories descended whilst their first-3-digit disaccord rates all ascended. In the same period,there were 7 categories＇ 4 th-digit disaccord rate ascended. The 5 th,6 th-digit disaccord rate of digestive system diseases ascended as well as a descend was explored in the category of neoplasm in the three years. Conclusion The analysis of admission and discharge ICD-10 coding accordance situation could reflect the trend of diagnostic accuracy,and provide practical information for the evaluation of diagnosis quality.