[1]肖 婷.基于DIP付费模式下对ICD编码质量的思考[J].医学信息,2022,35(01):35-38.[doi:10.3969/j.issn.1006-1959.2022.01.008]
 XIAO Ting.Thoughts on ICD Coding Quality Based on DIP Payment Mode[J].Medical Information,2022,35(01):35-38.[doi:10.3969/j.issn.1006-1959.2022.01.008]
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基于DIP付费模式下对ICD编码质量的思考()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
35卷
期数:
2022年01期
页码:
35-38
栏目:
出版日期:
2022-01-01

文章信息/Info

Title:
Thoughts on ICD Coding Quality Based on DIP Payment Mode
文章编号:
1006-1959(2022)01-0035-04
作者:
肖 婷
(西南医科大学附属医院病案与信息统计部,四川 泸州 646000)
Author(s):
XIAO Ting
(Department of Information and Statistics,Affiliated Hospital of Southwest Medical University,Luzhou 646000,Sichuan,China)
关键词:
按病种分值付费ICD编码编码质量医保支付
Keywords:
Disease-based score paymentICD codeCoding qualityHealth insurance payments
分类号:
R197
DOI:
10.3969/j.issn.1006-1959.2022.01.008
文献标志码:
A
摘要:
泸州市即将开展以“主要诊断+手术或操作”的组合形成病种的按病种分值付费试点工作,其主要数据依靠住院病案首页的疾病诊断和手术操作的ICD编码。本文从目前国内该领域的研究现状出发,对DIP付费模式、ICD编码等基本概念进行阐释,指出了ICD编码质量的重要性。然后通过对三级公立医院绩效考核中关于ICD编码方面的内容进行分析,总结了ICD编码的易错点,探讨了提升ICD编码质量的措施。最终为DIP付费模式提供真实数据支撑,推动医保支付方式改革。
Abstract:
Luzhou City is about to launch a pilot project of disease-based payment based on the combination of "main diagnosis + surgery or operation", the main data depends on the disease diagnosis on the first page of the hospitalized medical record and the ICD code of the surgical operation. Based on the current research status in this field in China, this paper explains the basic concepts such as DIP payment model and ICD coding, and points out the importance of ICD coding quality. Then, through the analysis of the content of ICD coding in the performance evaluation of tertiary public hospitals, the error-prone points of ICD coding are summarized, and the measures to improve the quality of ICD coding are discussed. Finally, it provides real data support for DIP payment mode and promotes the reform of medical insurance payment mode.

参考文献/References:

[1]国家医疗保障局办公室.国家医疗保障局办公室关于印发区域点数法总额预算和按病种分值付费试点城市名单的通知[EB/OL].http://www.nhsa.gov.cn/art/2020/11/4/art_37_3812.html,2020-11-04/2021-07-26.[2]国家医疗保障局办公室.关于印发国家医疗保障按病种分值付费(DIP)技术规范和DIP病种目录库(1.0版)的通知[EB/OL].http://www.nhsa.gov.cn/art/2020/11/20/art_37_3987.html,2020-11-20/2021-07-26.[3]国家医疗保障局办公室.关于印发疾病诊断相关分组(DRG)付费国家试点技术规范和分组方案的通知[EB/OL].http://www.nhsa.gov.cn/art/2019/10/24/art_37_1878.html,2019-10-24/2021-09-13.[4]傅卫,江芹,于丽华,等.DRG与DIP比较及对医疗机构的影响分析[J].中国卫生经济,2020,33(12):13-16.[5]武亮,艾迎春,李殿奎,等.基于Android技术的规培住院医师移动电子病历的研究[J].佳木斯大学学报(自然科学版),2019,37(2):281-283.[6]国家卫生计生委办公厅.国家卫生计生委办公厅关于印发住院病案首页数据填写质量规范(暂行)和住院病案首页数据质量管理与控制指标(2016版)的通知[EB/OL].http://www.nhc.gov.cn/yzygj/s2909/201606/26807a94a41d4550970317da7729218c.shtml.,2016-05-31/2021-07-26.[7]国务院办公厅.国务院办公厅关于加强三级公立医院绩效考核工作的意见[EB/OL].http://www.gov.cn/zhengce/content/2019-01/30/content_5362266.htm,2019-01-30/2021-07-26.[8]国家卫生健康委办公厅.关于启动2019年全国三级公立医院绩效考核有关工作的通知[EB/OL].http://www.gov.cn/xinwen/2021-03/31/content_5597121.htm,2021-03-31/2021-07-26.[9]万金兰,陈丹.三级公立中医医院绩效考核对住院病案首页数据质量的影响[J].中国病案,2021,22(3):19-22.[10]张晓娜,杨卫林.基于大数据技术的病案智能编码系统的功能设计与应用探究[J].科学技术创新,2021(3):82-83.[11]黄锋.病案首页诊断编码工作现状与发展趋势探讨[J].中华医院管理杂志,2018,34(6):458-461.[12]冯永.病案首页疾病编码问题的原因分析及对策[J].江苏卫生事业管理,2020:31(8):83-84.[13]叶婉茵,彭传薇,马欣祺,等.医院病案首页数据病案编码情况及改进措施分析[J].中国卫生标准管理,2021,12(14):4-6.[14]杜晓曦,张丽,王颖,等.病案书写质量对疾病分类准确性的影响[J].中国病案,2016,17(9):16-18.[15]许丹,肖鹏磊,滕俊玲.持续提升病案首页数据质量的探索[J].中华医院管理杂志,2019(2):41-43. [16]唐瑶,李凌,尹龙燕,等.临床医生质控员病历质量质控大赛结果分析与改进措施[J].现代医院,2020,20(5):679-681,685.[17]马茹君,纪艳,孙国梅.疾病编码质量的分析研究与对策[J].安徽卫生职业技术学院学报,2017,16(6):6-7.[18]杨惠萍.病案信息化管理在医院发展中的作用探讨[J].中国卫生标准管理,2020,11(2):1-3.[19]李增芳,丁松瑞,赵敏,等.公立医院绩效考核背景下某医院病历档案首页常见问题分析[J].医学信息,2020,33(22):145-146.[20]许速,谢桦,崔欣,等.基于大数据的病种分值付费的原理与方法[J].中国医疗保险,2020(9):23-28.

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更新日期/Last Update: 1900-01-01