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題名 | 疾病分類人員於疾病診斷關係群制度下之轉型與因應=The Transformation and Strategies of DRG System for Disease Classification Personnel |
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作者 | 林政彥; 李坤宥; 呂界一; 陳崇正; 鄒慕賢; 賴嬿淳; | 書刊名 | 病歷管理期刊 |
卷期 | 6:1 民95.11 |
頁次 | 頁50-57 |
分類號 | 419.26 |
關鍵詞 | 疾病分類; 國際疾病分類第九臨床修訂版; 診斷關係群; 病歷管理; Disease classification; International classification of disease,9[90bb]edition clinical modification; ICD-9-CM; Diagnositic related groups; DRGs; Medical record administration management; |
語文 | 中文(Chinese) |
中文摘要 | 中央健保局計畫以疾病診斷關係群做為支付基準的總額支付制度,期望藉此能夠突破近年來健保醫療費用支出日益增加的瓶頸,疾病診斷關聯群其中的每項支付類別,皆以疾病分類人員於國際疾病分類第九臨床修訂版(International classification of disease, 9th edition, clinical modification, ICD-9-CM)編碼來做為分類基礎,透過疾病分類人員針對病歷所做的ICD-9-CM編碼將間接影響到醫院的總收入。 專業人員可藉由參考國際上實際成功的案例研擬因應台灣健保相關制度之策略,疾病分類人員從一個僅僅只是提供醫院臨床疾病統計研究的幕後人員,已隨著 DRGs制度之實施而轉型,成為直接影響到整個醫院的醫療費用收入的第一線人員,故疾病分類人員的專業性、正確性以及迅速性更為重要,本文於探討中提供了疾病分類人員幾項建議,並建議疾分人員在面對此重大的轉變過程中之因應方法。 |
英文摘要 | The Bureau of National Health Insurance plans to administer the Global Budget System which is paid by DRGs. They hope that can dispose of the bottleneck in the dramatic daily increase in expenditure under the Health Insurance. Every classification in DRGs is based on the ICD-9-CM codes (International Classification of Disease, 9th Edition, Clinical Modification) which are coded by Disease Classification Coders. It will effect the income of hospitals indirectly when doing ICD-9-CM codes to case history by disease classification coders. A professional administrator can introduce a strategy to respond to The Taiwan Healthy Care Insurance by consulting international successful cares. From the administration of DRGs, the Disease Classification Coders who originally assisted in providing the research in clinical disease statistics have become first line staff members who can directly impact the medical income expenses for an entire hospital. So Coders becoming more efficient, professional, and accurate is crucially important. Some suggestions are put forward in this article for the coders who face this important challenge. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。