分析某院入组低风险死亡原因改进工作质量的研究
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摘要
目的分析入组为低风险死亡病例存在的问题,找出改进工作的方法,从而提高工作质量。方法将2015年度某院出院患者的病案首页信息通过DRGs分组器处理后,对2015年度入组低风险死亡病例进行入组原因分析,找出其中原因并针对这些问题制定改进措施后于2017年进行实践研究。结果通过加强病案管理和医疗质量管理,医院总死亡人数由528例下降到504例,总死亡人数占比由0.739%下降到0.616%;入组低风险死亡病例由8例下降到3例,入组低风险死亡病例占比由0.011%下降到0.004%。结论分析入组低风险死亡病例情况,能快速、有效发现病案管理及医疗质量管理存在的问题,并及时实施改进措施,从而提高医院病案管理及医疗管理质量。
Objective To analyze the problems existing in low-risk death cases and find out ways to improve work quality. Methods After the first page of the medical records of patients discharged from a hospital in 2015 was processed by the DRGs grouper, the reasons for the grouping of low-risk deaths in 2015 were analyzed, the causes were identified and the improvement measures were taken for these problems in 2017. Results By strengthening medical record management and medical quality management, the hospital total number of deaths decreased from 528 to 504,and the total death proportion in the hospital decreased from 0.739% to 0.616%. The number of low-risk deaths decreased from 8 to 3, and the proportion of low-risk deaths in the hospital dropped from 0.011% to 0.004%. Conclusion By analyzing the cases of low-risk deaths, the problems of medical record management and medical quality management can be found out quickly and effectively, and the improvement measures can be implemented timely, so as to improve the quality of hospital medical record management and medical management.
Objective To analyze the problems existing in low-risk death cases and find out ways to improve work quality. Methods After the first page of the medical records of patients discharged from a hospital in 2015 was processed by the DRGs grouper, the reasons for the grouping of low-risk deaths in 2015 were analyzed, the causes were identified and the improvement measures were taken for these problems in 2017. Results By strengthening medical record management and medical quality management, the hospital total number of deaths decreased from 528 to 504,and the total death proportion in the hospital decreased from 0.739% to 0.616%. The number of low-risk deaths decreased from 8 to 3, and the proportion of low-risk deaths in the hospital dropped from 0.011% to 0.004%. Conclusion By analyzing the cases of low-risk deaths, the problems of medical record management and medical quality management can be found out quickly and effectively, and the improvement measures can be implemented timely, so as to improve the quality of hospital medical record management and medical management.
引文
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[14]苗丽琼,山德生,李礼,等.疾病诊断相关组在绩效管理体系中的应用研究[J].中国医院统计,2015,22(4):258-260,263.
[15]严少彪,宋萍,李准,等.DRGs在重庆某三甲医院住院绩效管理中的应用[J].现代医院管理,2017,15(5):30-34.
[16]吴静娜.医院绩效管理及评价方法的应用[J].现代医院,2017,17(12):1753-1756.
[2]简伟研,胡牧,张修梅.基于DRGs的医疗服务绩效评估方法与案例应用研究[J].中华医院管理杂志,2013,29(3):181.
[3]王凤玲,刘晶,季新强,等.基于DRGs死亡风险分级在医疗质量评价中的应用[J].中国医院管理,2017,37(3):46.
[4]王文凤,陈静,刘婉莹,等.运用BJ-DRGs监测低风险死亡病例改进医疗质量的研究[J].中华医院管理杂志,2015,31(7):521.
[5]刘魏,李彩虹.我院DRGs入组数据分析及对策探讨[J].中国医院管理,2014,34(6):31-32.
[6]刘明跃,王迪,邓艳宁,等.住院病案首页对DRGs绩效评价的影响[J].中国病案,2018,19(2):37.
[7]舒琴,李迪,胡靖琛,等.DRGs评价医院绩效的SWOT分析[J].中国卫生质量管理,2018,25(2):7.
[8]吴植茆,吴良明,陈建平,等.基于DRGs的病案编码质量监测与分析[J].中国病案,2018,19(3):4.
[9]王志刚,潘莉,蔡静.RBRVS和DRGs与医院常用绩效评价方法的比较研究[J].中国医疗管理科学,2016,6(1):14-22.
[10]陆烨,尹芹,俞群俊,等.DRGs与医院绩效管理和内部控费的研究进展[J].中国卫生标准管理,2017,8(23):27-30.
[11]李景福,李冬岩,王珊珊,等.基于DRGs成本质量评价的绩效管理研究[J].农业与技术,2015,35(19):199-202.
[12]谢世堂.基于DRGs的出院人次相对价值评价方法研究[J].中国卫生经济,2016,35(3):79-81.
[13]杨莉.DRGs应用于医院绩效管理的实践与思考[J].医学教育管理,2017,3(5):392-396,402.
[14]苗丽琼,山德生,李礼,等.疾病诊断相关组在绩效管理体系中的应用研究[J].中国医院统计,2015,22(4):258-260,263.
[15]严少彪,宋萍,李准,等.DRGs在重庆某三甲医院住院绩效管理中的应用[J].现代医院管理,2017,15(5):30-34.
[16]吴静娜.医院绩效管理及评价方法的应用[J].现代医院,2017,17(12):1753-1756.