頁籤選單縮合
題名 | 各層級醫院疾病分類人員工作時間和內容之比較=Comparison of Coder's Job at Hospitals of Various Levels in Terms of Working Hours and Job Content |
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作者 | 楊美雪; 潘大永; 范春寶; 張樹棠; 葉碧玉; | 書刊名 | 病歷資訊管理期刊 |
卷期 | 9:1 2009.09[民98.09] |
頁次 | 頁68-82 |
分類號 | 419.24 |
關鍵詞 | 疾病分類人員; 工作負荷; 疾病分類編碼; Coder; Workload; ICD coding; |
語文 | 中文(Chinese) |
中文摘要 | 目的:分析國內各層級醫院疾病分類工作人員工作現況,提供醫院人力資源管理相關決策之參考。 方法:以結構式問卷調查2004年度醫院評鑑合格之地區醫院以上之疾病分類人員,採郵寄問卷方式收集資料,共發出問卷621份,回收有效問卷347份,回收率55.88% 。資料分析包括描述性統計、卡方檢定及單因子變異數分析。 結果:各級醫院疾病分類人員在每週工作時數上並未有顯著差異。在出院病歷疾病分類編碼每人每週平均編碼的工作負荷上,醫學中心為167.15+49.53 本、區域教學醫院為135.63+69.10 本、區域醫院醫院為158 . 82 + 159.94 本、地區教學醫院為112.35 + 52.96 本、地區醫院則為48 . 65 +79 . 72 本,醫學中心的出院編碼數顯著多於地區教學醫院( P<0.05 ) 及地區醫院( P<O.OOl) ,地區醫院顯著地少於其他層級醫院,區域教學醫院(P <O.oo I)、區域醫院(P <O . OOl )與地區教學醫院(P<O.Ol )。各級醫院疾分人員工作分析發現其經常執行之工作項目共計有出院疾病分類編碼、門急診疾病分類編碼、疾病分類編碼交叉審查等十八項,除執行疾病分類編碼主要工作項目外,尚須負責位院日控制、衛生主管機關及司法業務、勞保局及商業保險公司業務等非專業編碼性的工作。 結論:各級醫院疾病分類人員之工作項目內容相近,但除出院疾病分類編碼項目比重較一致外,其餘所執行項目的差異性卻頗大。地區教學醫院以上疾病分類人員工作負荷較重,建議增加其疾病分類人員人數,降低疾病分類人員工作負荷,以提升編碼正確性及完整性。 |
英文摘要 | Objectives: To analyze the current work conditions of coders serving at hospitals of different levels in Taiwan and provide useful data for the hospital to optimize its policy on relevant manpower resource management. Methods: A self-administered constructive questionnaire was mailed to 621 coders of all accredited hospitals, of regional level and above, nationwide in 2004 to gather needed information. The number of useable responses collected was 347 with a valid return rate of 55.88%. The data process followed included a descriptive statistical analysis, Chi-square test, and ANOVA. Results: There were no significant differences in weekly working hours at hospitals of different levels. However, the mean workload in terms of case number to deal with in a week in the discharge record category of ICD coding for a coder employed by a medical center, a regional teaching hospital, a regional hospital, a district teaching hospital, or a district hospital happened to be 167.15±49.53, 135.63±69.10, 158.82±159.94, 112.35±52.96, or 48.65±79.72, respectively. It appears such number of ICD coding, say, at a medical center was significantly higher than that at a district teaching hospital (P<0.05) or at a district hospital (P<0.001). The number at a district hosp ital appeared to be significantly fewer than those at hospitals of all other levels studied, e.g. a regional teaching one (P<0.001), a regional one (P<0.001), and a district teaching one (P<0.01) From the study we discovered that a coder was required to carry out 18 routine tasks, such as ICD coding of discharge record, that of outpatient ER, cross review of ICD coding, etc. Aside from those routine coding specialties, a coder also had to be responsible for hospitalization date control and other non-specialty record coding management in dealing with health competent authorities, legal matters, Bureau of Labor Insurance business, and commercial insurance companies. Conclusions: The job content of a hospital coder in terms of task items was rather similar across the spectrum of hospital levels. However, except the weight of discharge record ICD coding being alike to one another, the variation of the rest items seemed to be quite large. It appears the workload of a coder working for a hospital at the district teaching hospital level or above was simply too heavy to do a good enough job. Thus our recommendation is to increase the number of coders as to reduce her or his workload to improve the coding accuracy and integrity. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。