PDCA在DRGs模式下的眼科医院病案首页管理中的应用  

Application of PDCA in Front Page Management of Ophthalmic Hospital Medical Record Under DRGs Mode

作　　者：韦献 滕翠英 阮鹏 莫雄钧 邓秋丽 甘孟希 WEI Xian;TENG Cuiying;RUAN Peng;MO Xiongjun;DENG Qiuli;GAN Mengxi(Department of Quality Control,Liuzhou Red Cross Hospital,Liuzhou Guangxi 545001,China)

机构地区：[1]柳州市红十字会医院质控科,广西柳州545001

出　　处：《中国卫生标准管理》2022年第13期152-155,共4页China Health Standard Management

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题(Z20200607)。

摘　　要：目的探讨PDCA循环在DRGs模式下对眼科医院住院病案首页质量和DRGs入组正确率的管理效果。方法以2019年7—12月1452份医保病历作为对照组,2020年1月开始按照PDCA的实施步骤开展管理,以2020年7—12月1678份医保病历作为观察组,并将两组与DRGs入组有关的病案首页质量项目指标数据及DRGs入组正确率进行对比,对开展PDCA循环法的实施效果进行评价。结果实施PDCA循环法后,主要诊断选择正确率由92.0%提升至98.2%、主要手术及操作选择正确率由91.2%提升至97.8%、其他诊断填写完整正确率由90.6%提升至96.9%、主要诊断编码正确率由92.3%提升至97.6%、手术及操作编码正确率由91.7%提升至98.6%、其他诊断编码正确率由94.2%提升至98.2%、住院病案首页项目填报完整率由96.5%提升至100%、住院病案首页上传正确率由94.9%提升至99.1%、DRGs正确入组率由88.7%提升至96.5%,组间对比差异有统计学意义(P<0.05)。结论PDCA循坏法在DRGs模式下可以有效改善住院病案首页质量,提高DRGs正确入组率,优化医院基础数据质量和精细化管理水平。Objective To explore the management effect of PDCA cycle in DRGs mode on the quality of the first page of inpatient medical records and the accuracy of DRGs inclusion in ophthalmic hospitals.Methods A total of 1452 medical records from July to December 2019 were taken as the control group,and management was carried out according to the implementation steps of PDCA from January 2020.1678 medical records from July to December 2020 were taken as the observation group,and the index data of the first page quality of medical records related to the inclusion of DRGs and the accuracy of the inclusion of DRGs were compared between the two groups.Evaluated the implementation effect of PDCA cycle.Results After the PDCA cycle was implemented,the correct rate of major diagnosis selection increased from 92.0%to 98.2%,the correct rate of major surgery and operation selection increased from 91.2%to 97.8%,the correct rate of other diagnosis filling increased from 90.6%to 96.9%,the correct rate of major coding increased from 92.3%to 97.6%,the correct rate of operation and operation coding increased from 91.7%to 98.6%,the accuracy rate of other diagnostic codes increased from 94.2%to 98.2%,the completion rate of items on the home page of inpatient medical records increased from 96.5%to 100%,the accuracy rate of uploading the home page of inpatient medical records increased from 94.9%to 99.1%,and the correct DRGs inclusion rate increased from 88.7%to 96.5%.There were statistically significant differences between groups(P<0.05).Conclusion PDCA cycle in DRGs mode can effectively improve the quality of the first page of inpatient medical records,improve the correct inclusion rate of DRGs,optimize the quality of hospital basic data and fine management level.

关 键 词：PDCA循环法 眼科医院 住院病案首页 DRGs正确入组率 医院精细化管理 改进措施 

分 类 号：G271[文化科学—档案学]