DRG背景下病案科的精细化管理
Refined Management of the Medical Records Department Under the Background of DRG
黎俊 1周王艳 2唐再丽2
作者信息
- 1. 南华大学衡阳医学院南华大学附属第二医院DRGs办公室,湖南省,衡阳市,421000
- 2. 南华大学衡阳医学院南华大学附属第一医院病案室,湖南省,衡阳市,421001
- 折叠
摘要
DRG工作在我国全面铺开,为了适应DRG医保支付带来的挑战,病案科需要提升全面精细化管理.以某院病案科为例,优化病案签收归档流程、实现历史病案的数字化以及未来病案的无纸化;优化病案首页质控流程,采用出院病案的1次全流程4级质控审核体系和医保DRG分组返回问题病案的2次全流程审核,实现智能辅助编码,新增病案反馈功能、编码质控和结果显示功能,实时反馈给编码员,实施病案统计信息化,通过培训统计人员数据库知识,实现数据库统计查询;加强人员储备和人才培训.通过以上途径实现工作效率和工作质量的提高,实现病案首页书写和编码质量的提高,使医院在DRG医保支付中实现收支平衡.
Abstract
DRG(Diagnosis Related Groups)work is rapidly and comprehensively spreading in China.In order to adapt to the challenges brought by DRG medical insurance payment,the medical records department must adopt comprehensive and refined management.Taking a certain hospital as an example,refined management will be achieved from the following three aspects.First,the medical record signing and archiving process is optimized,the digitization of historical medical records is realized,and future medical records are made paperless.Second,the quality control process on the front page of medical records is optimized.A full-process 4-level quality control review system for discharged medical records and two full-process reviews of problematic medical records returned by medical insurance DRG groups are adopted.Intelligent auxiliary coding is realized,while the medical record feedback function,coding quality control,and result display function are added.Real-time feedback to coders is provided,and medical record statistics informatization is implemented.Database statistical queries by training statisticians on database knowledge are implemented.Third,personnel reserves and talent training are strengthened.Through the above methods,work efficiency and work quality can be improved,and the quality of writing and coding on the front page of medical records can be improved so that the hospital can achieve a balance between revenue and expenditure in DRG medical insurance payment.
关键词
病案科/DRG/精细化管理Key words
Department of medical record/DRG/Refined management引用本文复制引用
基金项目
湖南省社会科学成果评审委员会立项项目(2021)(XSP21YBC384)
出版年
2024
NETL
NSTL
万方数据