胃外科操作编码对科室CMI值的影响  

Effect of Gastric Surgery Operation Coding on Department CMI Values

作　　者：杨菁[1] 孙彦[1] 涂晓贤[1] YANG Jing;SUN Yan;TU Xiaoxian(Medical Record Office,Fujian Medical University Union Hospital,Fuzhou Fujian 350001,China)

机构地区：[1]福建医科大学附属协和医院病案室,福建福州350001

出　　处：《中国卫生标准管理》2023年第9期13-16,共4页China Health Standard Management

摘　　要：目的 探讨胃外科静脉注射化学治疗编码对疾病诊断相关分类(diagnosis related groups,DRGs)相关指标的影响,为即将开展DRGs的医院和基层医院进行参考借鉴。方法 提取2021年6月1—30日、2022年5月1日—6月30日胃外科出院患者的病案首页数据和DRGs系统分析数据,利用SPSS26.0统计学软件中t检验、Kruskal-Wallis检验分析其DRGs相对权重值(relative weight,RW)、权重值等变化是否受缺失静脉注射化疗药物等操作编码以及出院患者入组病例数的影响。结果 2021年6月、2022年5—6月每个月份RW都存在不同的差异性(t=13.475,P <0.001);Kruskal-Wallis检验分析每个月的DRG病组的RW与病组例数差异无统计学意义(P=0.47),说明DRG病组的RW不受出院患者病组例数影响。结论 静脉注射化疗药物操作编码的缺失会减少化学治疗患者入组的DRGs的RW,从而影响科室和医院的病例组合指数值(case combination index,CMI),使其科室或医院不能反映真实的工作量及救治患者的真实情况。Objective To explore the impact of intravenous chemotherapy codes in gastric surgery on related indicators of diagnosis related groups(DRGs),so as to provide reference for hospitals and primary hospitals that will carry out DRGs.Methods First page data and DRGs system analysis data of discharged gastric surgery patients from June 1 to 30,2021 and May 1 to June 30,2022 were extracted.t test and Kruskal-Wallis test in SPSS 26.0 statistical software were used to analyze whether the changes in DRGs’relative weight(RW)and weight value were affected by operation codes such as missing intravenous chemotherapy drugs and the number of enrolled patients.Results The RW in June 2021 and May to June 2022 had different differences(t=13.475,P<0.001).Kruskal-Wallis test showed no statistical significance in the number of cases between the DRG disease group and the disease group in each month(P=0.47),indicating that the RW of the DRG disease group was not affected by the number of cases in the discharged patients.Conclusion The absence of the operation code of intravenous chemotherapy drugs will reduce the RW of the DRGs enrolled in chemotherapy patients,resulting in the case combination index(CMI)of departments and hospitals,so that the departments or hospitals can not reflect the real workload and the real situation of patients treated.

关 键 词：操作编码 DRG CMI值 静脉注射化疗药物 分析 影响 

分 类 号：R195[医药卫生—卫生统计学]