医务人员对DRGs的认知度调查及思考

Investigation and thinking of the medical staff's recognition of diagnosis related groups

目的:了解医务人员对疾病诊断相关组(DRGs)、国际疾病分类(ICD编码)与病例组合指数(CMI)关系的认知情况及被调查者对DRGs、ICD编码与CMI指数关系进一步学习的意愿,分析其影响因素、探讨提高病案首页填写质量的方法和对策。方法:采取分层随机抽样方法选取上海市第一人民医院宝山分院的卫生技术人员200名进行问卷调研,调查内容主要包括工龄,职务,学历,职称,对DRGs、ICD编码、CMI指数的认知度和对DRGs、ICD编码与CMI指数关系进一步学习的意愿等。结果:不同工龄、职务、学历、职称的医务人员对DRGs、ICD编码、CMI指数的认知度差异均存在统计学意义(P <0.05);不同工龄、职务、学历、职称的医务人员进一步学习DRGs相关知识的意愿差异没有统计学意义(P> 0.05),其中高职称、高学历、工龄较长的医务人员对DRGs、ICD编码、CMI指数的相关知识了解程度更高。结论:应通过加强对医务人员相关知识的培训提升病案首页质量,才能真实有效的反映医院收治疾病的疑难复杂程度和诊疗技术水平。

Objective: To understand the medical staff's awareness of the relationship between diagnosis related groups(DRGs), international classification of diseases(ICD coding) and case mix index(CMI), and the willingness of respondents to further study the relationship between DRGs, ICD coding and CMI, and analyze its influencing factors in order to explore ways and countermeasures to improve filling quality of front page of medical records. Methods: A stratified random sampling method was used to select 200 health technicians from Baoshan Branch of Shanghai First People's Hospital for questionnaire survey, and the main contents of the survey included length of service, position, education, professional title, recognition of DRGs, ICD coding, CMI, and willingness to further study the relationship between DRGs, ICD coding and CMI. Results: There were significant differences in the awareness of DRGs, ICD coding and CMI among medical staffs with different length of service, positions, educational backgrounds and professional titles( P <0.05). There was no significant difference in the willingness of medical staffs with different length of service, positions, educational backgrounds and professional titles to further learn DRGs-related knowledge( P >0.05). Among them, medical staffs with high professional titles, high education, and long length of service had a higher level of understanding knowledge about DRGs, ICD coding, and CMI. Conclusion: The quality of the medical record home page should be improved by strengthening the training of relevant knowledge of medical personnel, so as to truly and effectively reflect the complexity of the hospital's treatment of diseases and the level of diagnosis and treatment technology.