病案首页ICD编码的准确率对DRGs付费影响

doi:10.3969/j.issn.1000-8535.2022.06.020

广州医药 ›› 2022, Vol. 53 ›› Issue (6): 96-99.DOI: 10.3969/j.issn.1000-8535.2022.06.020

病案首页ICD编码的准确率对DRGs付费影响

李小丹, 梁嘉诚, 邝倩仪, 杨凤娟, 胡朝晖, 刘顺娣, 范晓琳, 许名东

佛山市三水区人民医院病案室(佛山 528100)

收稿日期:2022-02-06 出版日期:2022-11-20 发布日期:2022-11-30
基金资助:
佛山市科技攻关项目(2020001004255)

Influence of the front page ICD coding accuracy of medical records on DRGs score payment system

LI Xiaodan, LIANG Jiacheng, KUANG Qianyi, YANG Fengjuan, HU Zhaohui, LIU Shundi, FAN Xiaolin, XU Mingdong

Medical-record Department,Sanshui People's Hospital,Foshan 528100,China

Received:2022-02-06 Online:2022-11-20 Published:2022-11-30

摘要/Abstract

摘要： 目的探寻病案首页国际疾病分类(ICD)编码的准确率对按疾病诊断相关分组(DRGs)分值付费影响。方法整体抽取2019年心血管内科和脊柱关节外科医保病例,分析DRGs分值付费存在的问题,对全院病案首页ICD编码采取相应的干预措施。结果 2019年病案首页ICD编码准确率为81.55%,DRGs分值付费亏损2 812 804.7元,经干预后,2020年病案首页ICD编码准确率为97.13%,DRGs分值付费结余14 089 039.36元。结论准确、规范的填写病案首页ICD编码,提高病案首页ICD编码的准确率,避免医院在DRGs分值付费模式下出现亏损有重要意义。

关键词: 病案首页, ICD编码, 准确率, DRGs付费

Abstract: Objective To investigate the influence of the front page International Classification of Diseases(ICD) coding accuracy of medical records on diagnosis related groups(DRGs) score payment system.Methods Medical insurance cases of cardiovascular medicine and spine and joint surgery in 2019 were totally selected,the problems of DRGs score payment system were investigated and analyzed,and managements improving the ICD coding on the medical records of discharged patients were carried out.Results In 2019,the accuracy of ICD coding of medical records was 81.55%,and the DRGs score payment system had lost 2 812 804.7 yuan.After improving,in 2020,the ICD coding accuracy achieved 97.13%,and DRGs score payment system had a positive balance of 14 089 039.36 yuan.Conclusions The accuracy and standardization of ICD coding on the medical records is of great significance in avoiding losses on DRGs score payment system.

Key words: first page of medical record, ICD code, accuracy, DRGs payment system

李小丹, 梁嘉诚, 邝倩仪, 杨凤娟, 胡朝晖, 刘顺娣, 范晓琳, 许名东. 病案首页ICD编码的准确率对DRGs付费影响[J]. 广州医药, 2022, 53(6): 96-99.

LI Xiaodan, LIANG Jiacheng, KUANG Qianyi, YANG Fengjuan, HU Zhaohui, LIU Shundi, FAN Xiaolin, XU Mingdong. Influence of the front page ICD coding accuracy of medical records on DRGs score payment system[J]. Guangzhou Medical Journal, 2022, 53(6): 96-99.

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病案首页ICD编码的准确率对DRGs付费影响

Influence of the front page ICD coding accuracy of medical records on DRGs score payment system

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