DRGs付费联合病案质量评价模式对医院病案管理及编码质量的影响

Influence of DRGs Payment Joint Medical Record Quality Evaluation Model on Hospital Medical Record Management and Coding Quality

目的:分析疾病诊断相关分类(DRGs)付费模式联合病案质量评价模式对医院病案管理及编码质量的影响。方法:选取2019年1—12月汕尾市海丰县彭湃纪念医院收治的200例患者的病案为对照组,采取DRGs付费模式联合常规病案管理方法;选取2022年1—12月同院收治的200例患者的病案为试验组,采取DRGs付费模式联合病案质量评价模式。比较两组病案编码质量、管理质量、编码错误类型。结果:试验组编码完成率高于对照组,编码完成时间短于对照组,错误率低于对照组(P<0.05);试验组病案缺陷总发生率低于对照组(P<0.001);试验组当天归档率高于对照组,丢失率、差错率低于对照组(P<0.05);试验组诊断不当、编码遗漏、细目水平错编、亚目水平错编发生率及总发生率低于对照组(P<0.05)。结论:DRGs付费模式联合病案质量评价模式可提高医院病案管理及编码质量,降低病案编码错误总发生率。

Objective:To analyze the influence of diagnosis related groups(DRGs)payment model combined with medical record quality evaluation model on hospital medical record management and coding quality.Methods:The medical records of two hundred patients admitted to Shanwei Haifeng County Pengpai Memorial Hospital from January to December 2019 were selected as the control group,and DRGs payment mode combined with conventional medical records management method was adopted.The medical records of two hundred patients admitted to the same hospital from January to December 2022 were selected as the experimental group,and the DRGs payment model combined with the medical record quality evaluation model was adopted.The coding quality,management quality and coding error types of the two groups of medical records were compared.Results:The coding completion rate of experimental group was higher than that of control group,the coding completion time was shorter than that of control group,and the error rate was lower than that of control group(P<0.05);The total incidence of defects in experimental group was lower than that in control group(P<0.001);The archiving rate of experimental group was higher than that of control group,and the loss rate and error rate were lower than that of control group(P<0.05);The incidence and total incidence of misdiagnosis,coding omission,miscoding of detail level and subunit level in experimental group were lower than those in control group(P<0.05).Conclusion:The combination of DRGs payment model and medical record quality evaluation model can improve the quality of medical record management and coding,and reduce the total incidence of medical record coding errors.