病案首页疾病编码质量提升对DRGs绩效综合评价的影响

Influence of Quality Improvement of Disease Coding in Medical Records Home Page on DRGs Performance Comprehensive Evaluation

目的探讨病案首页疾病编码质量提升对疾病诊断相关分组(DRGs)绩效综合评价的影响。方法整理分析医院病案首页疾病诊断编码缺陷明细和DRGs具体指标,采用卡方检验或Fisher精确检验对2019—2020年缺陷例数进行比较,采用TOPSIS法对医院同期DRGs绩效综合评价指标进行排序。结果该院2020年出院病案缺陷例数(20例,0.033%)较2019年(406例,0.603%)呈现明显下降趋势,差异有统计学意义(P<0.001)。从TOPSIS法评价结果来看,医院同期值从0.488上升至0.512,医院DRGs综合绩效不断提升,与该院病案首页质量提升趋势一致。结论通过有效提升病案首页疾病诊断编码质量,为DRGs绩效综合评价和医疗质量提升奠定了坚实基础。

Objective:To explore the effect of quality improvement of disease coding in medical records home page on performance comprehensive evaluation of disease diagnosis related groups(DRGs).Method:The defect details of disease diagnosis coding and DRGs specific indicators on the home page of hospital medical records were collated and analyzed.The number of defects in 2019-2020 was compared by usingχtest or Fisher’s exact test,and TOPSIS method was used to rank the comprehensive evaluation indexes of hospital DRGs performance in the same period.Result:The number of defects in discharged medical records in 2020(20 cases,0.033%)was significantly lower than that in 2019(406 cases,0.603%),and the difference was statistically significant(P<0.001).From the evaluation results of TOPSIS method,the hospital’s corresponding period value increased from 0.488 to 0.512,and the comprehensive DRGs performance of the hospital kept improving,which was consistent with the quality improvement trend of the hospital’s medical record home page.Conclusion:The effective quality improvement of filling in the disease diagnosis coding on the home page of medical records lays a solid foundation for the comprehensive performance evaluation of DRGs and the improvement of medical quality.