PDCA循环管理模式对提高病案ICD-10编码准确率的影响探究  

Study on the Influence of PDCA Cycle Management Mode on Improving the Accuracy of ICD-10 Encoding of Medical Records

作　　者：杨成明 马兴龙[1] YANG Chengming;MA Xinglong(Department of Medical Records Management,the First People's Hospital of Zunyi,Zunyi,Guizhou Province,563000 China)

机构地区：[1]遵义市第一人民医院病案管理科,贵州遵义563000

出　　处：《中国卫生产业》2023年第22期95-98,共4页China Health Industry

摘　　要：目的探究PDCA循环管理模式对提高病案ICD-10编码准确率的影响。方法随机抽取遵义市第一人民医院编码管理人员作为研究对象,在常规管理开展期间(2019年11月—2020年11月)抽取9名编码管理人员作为对照组,在PDCA循环管理开展后(2021年9月—2022年9月)抽取9名编码管理人员作为研究组,分别在实施PDCA循环管理前后随机抽取200份病案,由编码专家组对住院病案首页主要诊断编码情况进行评价,对比实施PDCA循环管理模式前后编码准确率差异,以及实施干预前后编码人员相关知识掌握程度差异。结果对照组病案编码正确率91.00%显著低于研究组的96.50%,差异有统计学意义(P<0.05);对照组200份病案中错误18份,其中诊断与编码不匹配错误率最高,占错误编码的55.56%,其次为疾病编码未按规则合并,占比33.33%,研究组200份病案中错误7份,其中诊断与编码不匹配占比最高位42.86%,疾病编码未按规则合并占比其次为28.57%;研究组编码人员在错情处理、错情筛查、系统维护方面得分显著高于对照组,差异有统计学意义(P均<0.05)。结论将PDCA循环管理模式应用于ICD-10编码管理中有助于提高编码准确率和编码人员相关知识掌握情况,对维持医院病案信息数据准确性具有重要意义,具有促进医院医疗质量持续提升的应用价值,建议临床推广使用。Objective To explore the effect of PDCA cycle management mode on improving the accuracy of ICD-10 encoding of medical records.Methods The coding managers of the First People's Hospital of Zunyi were randomly selected as the research objects.During the period of routine management(from November 2019 to November 2020),9 coding managers were selected as the control group;after the PDCA cycle management was implemented(from September 2021 to September 2022),9 coding managers were selected as the study group.200 medical records were randomly selected before and after the implementation of PDCA cycle management,respectively,and the coding expert group evaluated the main diagnosis codes on the first page of inpatient medical records.The difference of coding accuracy before and after PDCA cycle management mode was compared,and the difference of coders'knowledge mastery before and after intervention was compared.Results The coding accuracy was 91.00%in the control group.It was significantly lower than 96.50% in the study group,and the difference was statistically significant(P<0.05).There were 18 errors in the 200 medical records of the control group,among which the mismatching error rate between diagnosis and coding was the highest,accounting for 55.56% of the wrong coding.Secondly,the disease codes were not combined according to rules,accounting for 33.33%.Among the 200 medical records in the research group,there were 7 errors,among which the mismatch between diagnosis and code accounted for the highest 42.86%,and the failure to combine disease codes according to rules accounted for the second highest 28.57%.The scores of the coders in the aspects of fault handling,fault screening and system maintenance in the research group were significantly higher than those in the control group,and the differences were statistically significant(all P<0.05).Conclusion The application of PDCA cycle management mode in ICD-10 coding management is helpful to improve coding accuracy and relevant knowledge of coding personnel,which is of g

关 键 词：PDCA循环管理 病案 ICD-10编码 编码准确率 

分 类 号：R197.323[医药卫生—卫生事业管理]