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| Analysis on the enrollment of DRGs in MDCQ group |
| Wang Yuqin, Zhao Qinhua, Duan Congzhe, Lu Yao, Hu Junjun |
| Zibo Central Hospital, Zibo 255000, China |
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Abstract DRGs payment mode has gradually become the main payment mode of China′s medical and health system reform and medical insurance system reform, and also plays a guiding role in hospital performance evaluation. Referring to a DRGs data platform, this paper calculates the simulation data of DRGs grouping before and after correcting the coding errors of main diagnosis and/or main surgical operation categories found in the coding quality control process of a hospital. Cases related to MDCQ blood, hematopoietic organs, immune diseases and dysfunction group were analyzed to discuss the basis for modifying the diagnosis and surgical operation code, so as to reflect the impact of diagnosis and surgical operation on DRGs enrollment. Medical institutions should be encouraged to attach importance to the data of the first page of medical records, especially to recognize the importance of correct selection of doctors and correct coding of coders in diagnosis and surgery information, and finally improve the rationality of DRGs inclusion by improving the correct coding rate of the first page of medical records.
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Received: 09 November 2021
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