[1]王尊晖.CHS-DRG细分组方案的编码数据分析[J].医学信息,2020,33(19):1-4.[doi:10.3969/j.issn.1006-1959.2020.19.001]
　WANG Zun-hui.Coding Data Analysis of CHS-DRG Subdivision Group Plan[J].Medical Information,2020,33(19):1-4.[doi:10.3969/j.issn.1006-1959.2020.19.001]
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CHS-DRG细分组方案的编码数据分析()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
33卷
期数:
2020年19期
页码:
1-4
栏目:
出版日期:
2020-10-01

文章信息/Info

Title:
Coding Data Analysis of CHS-DRG Subdivision Group Plan
文章编号:
1006-1959（2020）19-0001-04
作者:
王尊晖
杭州市儿童医院医教部，浙江 杭州 310014
Author(s):
WANG Zun-hui
Department of Medical Education,Hangzhou Children’s Hospital,Hangzhou 310014,Zhejiang,China
关键词:
CHS-DRG; DRG细分组; 主要诊断; 主要手术及操作; MCC; CC
Keywords:
CHS-DRG; DRG subdivision group; Main diagnosis; Main surgery and operation; MCC; CC
分类号:
TP311.1；R730
DOI:
10.3969/j.issn.1006-1959.2020.19.001
文献标志码:
A
摘要:
目的 分析医疗保障疾病诊断相关分组（CHS-DRG）细分组方案，以期为规范病案编码及学习DRG分组提供参考。方法 比较CHS-DRG细分组中疾病诊断、手术及操作、严重并发症或合并症（MCC）、并发症或合并症（CC）中编码与国家医保版疾病、手术及操作编码库中编码异同，查找影响DRG分组的主要编码。结果 CHS-DRG细分组中包含主要诊断编码28378条、主要手术及操作编码9102条、MCC和CC编码9765条；同一个诊断编码或手术及操作编码可进入多个ADRG中。医保疾病编码库中有3834条、手术及操作编码库中有3895条编码未纳入DRG分组中。MCC和CC中有9500条编码包含在主要诊断编码中，CC排除列表中所有编码均包含在主要诊断编码中。结论 对编码数据分析，可加深对病案编码及DRG分组的学习和理解，提高病案首页填写的规范性和准确性。
Abstract:
Objective To analyze the subdivision group plan of the medical insurance disease diagnosis related group (CHS-DRG), in order to provide a reference for standardizing medical record coding and learning DRG grouping.Methods Comparing the similarities and differences between the codes in disease diagnosis, surgery and operation, severe complications or comorbidities (MCC), complications or comorbidities (CC) in the CHS-DRG subdivision group and the codes in the national medical insurance version of disease, surgery and operation code library,find the main codes that affect DRG grouping.Results The CHS-DRG subdivision group contains 28378 main diagnostic codes, 9102 main surgery and operation codes, 9765 MCC and CC codes; the same diagnostic code or surgery and operation codes could enter multiple ADRGs. There were 3834 codes in the medical insurance disease code database, and 3895 codes in the surgery and operation code database were not included in the DRG groups. There were 9500 codes in MCC and CC included in the main diagnostic code, and all codes in the CC exclusion list were included in the main diagnostic code. Conclusion Analysis of coding data could deepen the learning and understanding of medical record coding and DRG grouping, and improve the standardization and accuracy of filling out the first page of medical records.

参考文献/References:

[1]国家医疗保障局办公室.关于印发医疗保障疾病诊断相关分组(CHS-DRG)细分组方案(1.0版)的通知(医保办发〔2020〕29号)[Z].2020-06-18. [2]董乾,陈金彪,陈虎,等.DRGs国内发展现状及政策建议[J].中国卫生质量管理,2018,25(2):1-4. [3]浙江省医疗保障局办公室.关于启用国家医保版疾病诊断和手术操作分类与代码的通知(浙医保办发〔2020〕3号)[Z].2020-01-22. [4]王珊,杨兴宇,于丽华,等.C-DRG的分组原则与方法[J].中国卫生经济,2017(6):9-11. [5]张中花,章浩然.基于DRG的安徽某大型三甲医院病案首页质量改进研究[J].卫生经济研究,2020,37(3):29-31,35. [6]殷人易.DRGs应用于医院管理的问题及缺陷探讨[J].中国医院管理,2019(3):60-61.

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更新日期/Last Update: 1900-01-01