基于DIP付费模式下对ICD编码质量的思考  

Thoughts on ICD Coding Quality Based on DIP Payment Mode

作　　者：肖婷 XIAO Ting(Department of Information and Statistics,Affiliated Hospital of Southwest Medical University,Luzhou 646000,Sichuan,China)

机构地区：[1]西南医科大学附属医院病案与信息统计部,四川泸州646000

出　　处：《医学信息》2022年第1期35-38,共4页Journal of Medical Information

摘　　要：泸州市即将开展以“主要诊断+手术或操作”的组合形成病种的按病种分值付费试点工作,其主要数据依靠住院病案首页的疾病诊断和手术操作的ICD编码。本文从目前国内该领域的研究现状出发,对DIP付费模式、ICD编码等基本概念进行阐释,指出了ICD编码质量的重要性。然后通过对三级公立医院绩效考核中关于ICD编码方面的内容进行分析,总结了ICD编码的易错点,探讨了提升ICD编码质量的措施。最终为DIP付费模式提供真实数据支撑,推动医保支付方式改革。Luzhou City is about to launch a pilot project of disease-based payment based on the combination of"main diagnosis+surgery or operation",the main data depends on the disease diagnosis on the first page of the hospitalized medical record and the ICD code of the surgical operation.Based on the current research status in this field in China,this paper explains the basic concepts such as DIP payment model and ICD coding,and points out the importance of ICD coding quality.Then,through the analysis of the content of ICD coding in the performance evaluation of tertiary public hospitals,the error-prone points of ICD coding are summarized,and the measures to improve the quality of ICD coding are discussed.Finally,it provides real data support for DIP payment mode and promotes the reform of medical insurance payment mode.

关 键 词：按病种分值付费 ICD编码 编码质量 医保支付 

分 类 号：R197[医药卫生—卫生事业管理]