Objective:To investigate whether standardized management of medical records front page within a medical consortium helps enhance the quality of claim forms related to diagnosis related group(DRG)payments and their settlement rates in primary community hospitals.Method:Using a tertiary hospital in a district of Nanjing as the central hospital and six primary community hospitals forming a medical consortium as the sample,a randomized controlled group comparison was conducted to assess the impact of standardized management of medical records on the quality of DRG payment settlement invoices and settlement rates.Results:Primary community hospitals under standardized management demonstrated significantly higher accuracy in reporting main diagnoses(95.33%±2.73%vs.91.96%±1.68%,P<0.05),main surgeries or procedures(96.63%±2.06%vs.89.85%±2.09%,P<0.05),lower omission rates for other diagnoses,surgeries,or procedures(9.26%±5.25%vs.25.59%±6.39%,P<0.05),reduced invoice revision rates(12.56%±3.59%vs.30.22%±4.75%,P<0.05),and higher settlement rates(105.33%±4.88%vs.94.59%±3.51%,P<0.05)compared to primary community hospitals without standardized management.Conclusion:Leveraging the expertise of coding personnel from the core hospital within the medical consortium to implement standardized management of medical records front page significantly improves the quality of DRG settlement invoices and increases settlement rates in primary community hospitals,indicating its potential for widespread implementation.
regional medical consortiamedical records front pagestandardized managementdiagnosis-related group
NETL
NSTL
维普
万方数据
