中国标准化Issue(14)：248-251,4.DOI:10.3969/j.issn.1002-5944.2024.14.046
DRG联合住院病案首页标准化控制对普外科病案缺陷的影响
Influence of Standardized Control on the First Page of DRG Combined Inpatient Medical Records on the Defects of General Surgery Records
摘要
Abstract
Objective:To explore the effect of standardized control of the first page of combined hospitalization medical records on the defect index of general surgery under DRG conditions.Methods:1200 inpatient records of DRG combined inpatient records were selected from Luliang City People's Hospital before and after standardized control,and the defect changes of general surgery cases were compared and analyzed.Results:After standardized control of the front page of medical records in DRG group,the defect rate of the front page of medical records in general surgery group was 4.83%,and before standardized control of the first page of medical records in DRG group was 20.25%,the difference between the two groups was significant(P<0.05).The 7 main defect types of the two groups were compared,and the incidence of each defect type after standardized control was lower than that before standardized control,the difference was statistically significant(P<0.05).After standardized control,the probability of data errors in the basic information of the first page of patients'medical records,hospitalization process and diagnosis and treatment information was significantly reduced(P<0.05).Conclusion:The combination of DRG and the standardized control of the front page of hospital medical records can significantly improve the quality of filling in the first page of general surgery medical records and the level of medical records management,and provide a basis for the quality control of the first page of medical records,which can be popularized and applied.关键词
DRG/住院病案首页/标准化控制/缺陷率/普外科Key words
DRG/hospital record first page/standardized control/defect rate/general surgery引用本文复制引用
王新芳..DRG联合住院病案首页标准化控制对普外科病案缺陷的影响[J].中国标准化,2024,(14):248-251,4.基金项目
本文受吕梁市软科学研究项目"医保按疾病诊断相关分组付费政策下病案首页质量控制模式研究"(项目编号:2021RKX-2-45)资助. （项目编号:2021RKX-2-45）
