边疆地区临床医师与编码员对疾病诊断相关分组知识的认知现状

Current Status of Clinicians and Coders’Cognition of Grouping Knowledge Related to Disease diagnosis in Frontier Areas

目的通过现况调查方法,了解边疆地区临床医师与编码员对疾病诊断相关分组(DRGs)知识的认知程度,为DRGs应用于质量评价、绩效考核、医保付费奠定基础。方法2018年7月11日-2018年11月20日采用自行设计调查问卷,对新疆地区4个地州6家医院的567名医务人员进行问卷调查。问卷的内部一致性信度Cronbahs’α为0.71;问卷的内容效度经过5位三级甲等医院的医务部、质管部等相关专家根据内容的相关性进行打分,CVI值为0.86。结果临床医师对DRGs知识认知的平均得分在39.61~56.52分之间,不同地区医师认知成绩也不同;不同学历的临床医师认知的成绩无统计学意义;不同职称及不同工作年限的临床医师认知成绩在44~50分之间,进行比较时有统计学意义;编码员对DRGs知识认知的平均得分高于临床医师的成绩,在52.50±18.19分之间。结论边疆地区临床医师与编码员对疾病诊断相关组知识的认知率较低,应引起医院有关管理部门的高度重视。采取相应措施加大教育培训力度,以提高临床医师与编码员对疾病诊断组相关知识认知水平及关注度。

Objectives To investigate the cognition degree of clinical physicians and coders on disease diagnoses-related grouping(DRGs)knowledge in frontier areas through the method of current situation survey,so as to lay a foundation for the application of DRGs in quality evaluation,performance appraisal and medical insurance payment.Methods From July 11st,2018 to November 20th,2018,a self-designed questionnaire was conducted among 567 medical staff from 6 hospitals in 4 prefectures in Xinjiang.The internal consistency reliability of the questionnaire,Cronbahs’α was 0.71.The content validity CVI value of the questionnaire was scored by the medical department,quality control department and other relevant experts of five first-class hospitals according to the relevance of the content,and the CVI value was 0.86.Results The average score of DRGs knowledge cognition of clinicians was 39.61~56.52,and the score of DRGs knowledge cognition of clinicians was different in different regions.There was no statistical significance in the cognitive scores of clinicians with different educational backgrounds.The cognitive scores of clinicians with different professional titles and working years were between 44 and 50,and the comparison was statistically significant.The average score of DRGs knowledge cognition of coders was higher than that of clinicians,between 52.50±18.19 points.Conclusions Clinicians and coders in frontier areas had a low awareness of knowledge related to disease diagnosis,which should be paid more attention to by the relevant administrative departments of hospitals.Measures should be taken to strengthen education and training so as to raise the awareness level and attention of clinicians and coders to the knowledge related to disease diagnosis group.