病案首页填报疾病诊断相关分组管理中应用PDCA循环的价值  

The value of applying the PDCA cycle in the management of disease diagnosis related groups on the first page of medical cases

作　　者：陆石娣 周苑琳 梁华香 冯钊雄 LU Shidi;ZHOU Yuanlin;LIANG Huaxiang;FENG Zhaoxiong(Department of Medical Records,Huangpu People's Hospital of Zhongshan,Zhongshan,Guangdong,528429,China)

机构地区：[1]中山市黄圃人民医院病案室,广东中山528429

出　　处：《当代医学》2024年第19期125-128,共4页Contemporary Medicine

基　　金：中山市医学科研项目(2022A020352)。

摘　　要：目的探究病案首页填报疾病诊断相关分组(diagnosis related groups,DRGs)管理中应用PDCA循环的价值。方法随机抽取2022年6—8月中山市黄圃人民医院记录的1500份病案作为对照组,2022年9—12月记录的1500份病案作为干预组。对照组采用DRGs管理分类汇总各错误情况,干预组实施基于DRGs管理的PDCA循环管理。比较两组病案首页填报错误率及总错误率、检查与DRGs相关性大的各项错误率。结果干预组基本信息、住院信息、诊断信息、符合情况、手术信息、费用信息的错误率及总错误率均低于对照组,差异有统计学意义(P<0.05)。干预组年龄、住院时间、诊断、手术及费用的错误率均低于对照组,差异有统计学意义(P<0.05),两组离院方式错误率比较差异无统计学意义。结论在病案首页填报DRGs管理中应用PDCA循环能显著提升病案首页填报的准确率,消除病案首页填报质量的影响因素,避免病案首页填报数据的失真,促病案首页填报质量的持续提高,为医院管理及后续市、省DRGs绩效评价体系的建立与DRGs付费系统的正常运行提供数据基础。Objective To explore the value of applying PDCA cycle in the management of disease diagnosis related groups(DRGs)on the first page of medical cases.Methods A total of 1500 medical records recorded in Huangpu People's Hospital of Zhongshan from June to August 2022 were randomly selected as the control group,and 1500 medical records recorded from September to December 2022 were selected as the intervention group.The control group was managed using DRGs to categorize and summarize the errors,the intervention group implemented PDCA cycle management based on DRGs management.The error rate of filling in the first page of medical records and total error rate,the error rate of checking each item with high relevance to DRGs were compared between the two groups.Results The error rates of basic information,hospitalization information,diagnosis information,compliance,operation information,cost information and total error rate in the intervention group were lower than those in the control group,and the differences were statistically significant(P<0.05).The error rates of age,hospitalization days,diagnosis,operation and cost in the intervention group were lower than those in the control group,and the differences were statistically significant(P<0.05),there was no significant difference in the error rate of the way of leaving the hospital between the two groups.Conclusion The application of PDCA cycle in the DRGs management of the first page filling of medical records can significantly improve the accuracy of the first page filling of medical records,eliminate the factors affecting the quality of the first page filling,avoid the distortion of the data of the first page filling of medical records,and promote the continuous improvement of the quality of the first page filling of medical records,it provides data basis for hospital management and subsequent establishment of municipal and provincial DRGs performance evaluation system and normal operation of DRGs payment system.

关 键 词：病案首页 填报质量 诊断相关分组管理 PDCA循环 

分 类 号：R19[医药卫生—卫生事业管理]