按病种分值付费亏损病案入组影响因素分析

doi:10.3969/j.issn.1006-5253.2023.04.008

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Abstract Objective To explore the influencing factors of the inclusion of the deficit medical records under the diagnosis-intervention packet (DIP).Methods A retrospective study was conducted on the home page contents of 21 436 deficit medical records in a tertiary public hospital from January to June 2022, and the influencing factors of DIP inclusion were analyzed.Results The most type of deficit medical records was the normal rate group, accounting for 84.27%. The type of medical insurance was medical insurance for residents, accounting for 87.45%. The number of deficit medical records was the the largest in the department of pediatrics, accounting for 9.00%, and the department of gastroenterology was the second, accounting for 8.31%. Among the factors influencing of the inclusion of deficit medical records under DIP, DIP grouping error accounted for 33.08%, high cost of medicine, medical consumables and inspection accounted for 15.05%, major diagnosis coding error accounted for 12.57%, correct inclusion with disease type score deviation accounted for 8.48%, and major surgical coding error accounted for 3.09%. Others accounted for 27.73%.Conclusion Medical institutions and medical insurance departments should strengthen cooperation and communication with third-party software development company. When coding, the medical record coders should avoid blindly retrieving the codes from computers, and code accurately according to coding rules. Medical institutions should strengthen clinical behavior control, promote rational diagnosis and treatment, and reasonably control medical resources and costs.

Key words： home page of medical record medical record coder diagnosis-intervention packet

Received: 17 November 2022

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	Ma Yingli

Cite this article:

Ma Yingli. Influencing factors of the inclusion of deficit medical records under the diagnosis intervention packet[J]. journal1, 2023, 30(4): 281-284.

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http://manu58.magtech.com.cn/Jwk_zgyytj/EN/10.3969/j.issn.1006-5253.2023.04.008 OR http://manu58.magtech.com.cn/Jwk_zgyytj/EN/Y2023/V30/I4/281

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