CAJ | 학술논문

目的：分析食管癌编码错误的原因，并提出对策。方法对我院2009年1月1日~2013年6月30日出院诊断为食管癌的病案进行回顾性分析。根据其发生部位，依据《疾病和有关健康问题的国际统计分类》(ICD-10第二版)的分类要求，对食管恶性肿瘤进行编码。结果114例诊断为食管癌病例中有60例编码错误，占所查病案的52.6%。结论对临床医师和病案管理人员进行相关知识教育是防止编码错误、提高编码质量的有效对策。
목적：분석식관암편마착오적원인，병제출대책。방법대아원2009년1월1일~2013년6월30일출원진단위식관암적병안진행회고성분석。근거기발생부위，의거《질병화유관건강문제적국제통계분류》(ICD-10제이판)적분류요구，대식관악성종류진행편마。결과114례진단위식관암병례중유60례편마착오，점소사병안적52.6%。결론대림상의사화병안관리인원진행상관지식교육시방지편마착오、제고편마질량적유효대책。
Objective Analyze the reason on esophageal cancer coding errors and come up with countermeasure. Methods To do a retrospective analysis on those who discharged diagnosis to esophageal cancer between January 1, 2009 and June 30, 2013 in our hospital. Encoding of esophageal malignancy accord to its occurrence site and base on the classification requirements of International statistical classification of disease and related Health Problem. Results 114cases diagnosed of esophageal cancer which has 60 coding errors, accounting for 52.6% of the cases inspection. Conclusion Educating clinicians and case management personnel about related knowledge is an ef ective countermeasure of preventing coding errors and improve coding quality.