病案首页质量对DRG支付的影响及对策分析  

Study on the Influence of Medical Record First Page Quality on DRG Payment and its Countermeasures

作　　者：李琳琳 李扬扬 朱英雪 王恩佑 袁美子 梁真真 乔记兵[2] Li Linlin;Li Yangyang;Zhu Yingxue(Shandong Provincial Third Hospital,Jinan,Shandong,250031,China;不详)

机构地区：[1]山东省立第三医院,山东济南250001 [2]山东省立医院,山东济南250021

出　　处：《中国医院管理》2024年第9期75-78,共4页Chinese Hospital Management

基　　金：2023年度山东省卫生健康委员会深化医改研究课题(YGY2023079)。

摘　　要：按疾病诊断相关分组(DRG)付费方式已在各级医院落地实行。与DRG有直接关联的病案首页质量管理,已成为医院管理工作的重要内容。病案首页质量的高低在一定程度上影响了DRG的入组,影响着医院医保支付,进而影响医院绩效考核和评价。通过实例重点探析了病案首页质量问题及其对DRG支付的影响,剖析了导致DRG病例未入组或入错组的原因,并提出了加强病案首页质量管理的对策,以期为医院管理和DRG支付管理工作提供实践参考。DRG has been applied in most hospitals.The quality management of the first page of medical records,which is directly related to DRG grouping,has become an important part of hospital management.To some extent,the quality of the first page of medical records affects the inclusion of DRG,the payment of medical treatment,and the performance assessment and evaluation of hospital.Through examples,it focuses on the quality problems of the first page of medical records and its impact on DRG payment,analyzes the reasons leading to the cases of DRG not entered in the group or in the wrong group,and puts forward countermeasures to strengthen the quality manage-ment of the first page of medical records,in order to provide theoretical support and practical reference for hospital management and DRG payment management.

关 键 词：病案首页 质量管理 疾病诊断相关分组 

分 类 号：R197.1[医药卫生—卫生事业管理]