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頁籤選單縮合
| 題 名 | DRGs線上稽核系統=A Study of the DRGs Online Auditing System |
|---|---|
| 作 者 | 鄭貴真; 廖學志; 汪文煌; 黃勝雄; | 書刊名 | 病歷管理期刊 |
| 卷 期 | 7:2 2008.04[民97.04] |
| 頁 次 | 頁1-14 |
| 分類號 | 419.21 |
| 關鍵詞 | 診斷關聯群; 前瞻性支付制度; 疾病分類; 臨床路徑; 主要診斷類別; 病例組合; Diagnosis related groups; Prospective payment; Disease classification; Clinical pathway; Major diagnostic category; Case-mix index; |
| 語 文 | 中文(Chinese) |
| 中文摘要 | 在全民健康保險面臨醫療費用不斷上漲的困境下,中央健康保險局提出住院部分之診斷關聯群為基礎的前瞻性支付制度,以減緩醫療費用高漲。健保局原預定於96年醫院全面申報969項Diagnosis Related Groups (DRGs))編碼,然而DRGs分類邏輯繁瑣,加上醫護人員及行政人員現有的工作負擔,極易增加編碼錯誤的發生機率。為了降低編碼錯誤,提升疾病分類品質,本研究使用雛型系統開發法建置DRGs線上稽核系統,以提升疾病分類編碼的適當性,降低申報時可能發生的人為疏失。由於系統建置於院內網路的環境上,醫護人員可於線上即時掌握該類疾病可用的醫療資源,並得知病人應遵循的臨床路徑以維護病人醫療照護品質,此外,醫院亦可即時向保險單位申請醫療費用,提升醫院資金靈活運用度。 |
| 英文摘要 | To deal with escalating medical care expenses, the Bureau of National Health Insurance (BNHI) proposed a forward-looking payment system that is based on the Diagnosis Related Groups (DRGs) for inpatient services. The BNHI planned to require hospitals to report all 969 DRG codings beginning in 2007. However, the likelihood of a coding error has increased as a result of the complex logic for DRGs classification and the existing workloads for medical personnel and administrative staff. To reduce coding errors and to improve the quality of disease classifications, this paper applies a prototype developing method to construct a DRG online auditing system. As part of the hospital's intranet, the system allows medical personnel to secure the resources to treat a particular disease and to track a patient's compliance with clinical pathway, thereby promoting quality care. Additionally, through use of this system, the hospital can more efficiency make insurance claims to receive timely payments and improve its financial standing. |
本系統中英文摘要資訊取自各篇刊載內容。