医院内国际疾病分类与编码培训现状的调查与思考  

Investigation and Reflection on the Training Status of ICD Coding in Hospitals

作　　者：江俊[1] 吴少平[2] Jiang Jun;Wu Shaoping(Department of Medical Record Management,The First Affiliated Hospital of Chengdu Medical College,Chengdu 610500,China;Department of Medical Imaging,Chengdu Medical College,Chengdu 610500,China)

机构地区：[1]成都医学院第一附属医院病案管理科,成都610500 [2]成都医学院医学影像系,成都610500

出　　处：《成都医学院学报》2018年第5期635-638,共4页Journal of Chengdu Medical College

基　　金：四川省高等教育人才培养质量和教学改革建设项目(川教函[2014]450号)

摘　　要：目的调查医院内国际疾病分类(ICD)编码的培训工作现状,探究其中存在的问题与解决要点。方法回顾2015～2017年成都医学院第一附属医院ICD编码内训工作情况。从组织者、受训者两个方面对相关人群开展问卷调查,了解前者对该工作重要性的认识与推动状况,了解后者对该知识的掌握和受训意愿等情况,由此分析其中存在的主要问题和原因,再与同类医院作横向比较。结果 3年来,本院ICD编码培训活动合计11次,含院级3次、科级5次及面向一年级研究生的专题讲座3次。从组织培训意愿来看,医保办较强烈,教培部较弱,但各部门均少有落实。在受训者方面,临床医师和研究生对于ICD编码、诊断相关分类(diagnosis related groups,DRGs)知识了解较多;住培学员的知晓情况差于临床医师,但二者各项指标变化趋势一致;而本科实习生则了解甚少。住培学员与研究生对相关知识的了解程度、价值认识差异有统计学意义(P<0.05)。同类医院的情况与之相仿。结论医院ICD编码培训工作急需加强,培训部门应面向不同的对象分类建设ICD编码课程并加强培训管理。Objective To investigate the coding training status of the international classification of diseases （ICD） in hospitals, explore the existing problems and provide the key solutions. Methods The internal training status of ICD coding from 2015 to 2017 in The First Affiliated Hospital of Chengdu Medical College was analyzed retrospectively. A questionnaire survey was conducted among the relevant organizers and trainees to explore the existing problems and potential causes and make comparisons with other similar hospitals by investigating the organizers＇ awareness and promotion of the ICD coding training and the trainers＇ mastery of ICD coding and training willingness. Results In the past three years, the trainings were implemented 10 times including 2 times of the hospital-level training, 5 times of the sector-level training and 3 times for first-year postgraduate students. As to the willingness to organize the training, the medical insurance department has a strong willingness, the teaching and training department has a weak willingness, and all the other departments have little willingness. In terms of trainees, clinicians and postgraduates have more knowledge about ICD coding and diagnosis related groups （DRGs）, and the resident standardized training students have less knowledge than clinicians but the changing trends of all the indicators between them were relatively similar. Undergraduate interns have little knowledge. There were significant differences in the mastery and awareness of ICD coding between the resident standardized training students and postgraduates （ P 〈0.05）. These problems existed in most of the similar hospitals. Conclusion There is an urgent need to strengthen the training of ICD coding in hospitals. The training department should build different ICD coding courses for different target groups and strengthen the training management.

关 键 词：国际疾病分类法 诊断相关分类 培训 继续教育 调查 

分 类 号：R197.3[医药卫生—卫生事业管理]