中华医院管理杂志
中華醫院管理雜誌
중화의원관리잡지
Chinese Journal of Hospital Administration
2015年
11期
875-878
,共4页
刘娅%李小娟%王越%费腾%张文静
劉婭%李小娟%王越%費騰%張文靜
류아%리소연%왕월%비등%장문정
诊断相关组(DRGs)%国际疾病分类(ICD)%病案首页%Logistic回归分析
診斷相關組(DRGs)%國際疾病分類(ICD)%病案首頁%Logistic迴歸分析
진단상관조(DRGs)%국제질병분류(ICD)%병안수혈%Logistic회귀분석
DRGs%International code of diseases(ICD)%Home page of medical record%Logistic regression analysis
目的 分析歧义病案产生的原因,为疾病相关组(diagnosis related groups,DRGs)奠定基础.方法 从2010年至2014年17 751份手术病案首页中按照主要诊断与主要手术的选择原则筛选出歧义病案268份,采用单因素卡方检验分析不同住院特征对歧义病案的影响,将有显著性差异的变量赋值后采用Logistic回归分析寻找歧义病案产生的影响因素.结果 17 751份手术患者住院病案首页中共有歧义病案268份,占全部手术病案的1.51％.Logistic回归分析结果显示:内科出院、死亡患者、转科、高龄、住院时间长、肿瘤患者都是导致歧义病案产生的危险因素,结果均有统计学意义(P＜0.05),其中出院科别(OR=6.595,95％ CI:5.043～8.625)、是否死亡患者(OR=3.787,95％CI:2.611～5.492)和是否转科(OR=2.746,95％CI: 2.061～3.659)是影响歧义病案发生率的重要危险因素.结论 通过对歧义病案产生原因的分析,为医院有针对性地开展病案质量管理提供依据.
目的 分析歧義病案產生的原因,為疾病相關組(diagnosis related groups,DRGs)奠定基礎.方法 從2010年至2014年17 751份手術病案首頁中按照主要診斷與主要手術的選擇原則篩選齣歧義病案268份,採用單因素卡方檢驗分析不同住院特徵對歧義病案的影響,將有顯著性差異的變量賦值後採用Logistic迴歸分析尋找歧義病案產生的影響因素.結果 17 751份手術患者住院病案首頁中共有歧義病案268份,佔全部手術病案的1.51％.Logistic迴歸分析結果顯示:內科齣院、死亡患者、轉科、高齡、住院時間長、腫瘤患者都是導緻歧義病案產生的危險因素,結果均有統計學意義(P＜0.05),其中齣院科彆(OR=6.595,95％ CI:5.043～8.625)、是否死亡患者(OR=3.787,95％CI:2.611～5.492)和是否轉科(OR=2.746,95％CI: 2.061～3.659)是影響歧義病案髮生率的重要危險因素.結論 通過對歧義病案產生原因的分析,為醫院有針對性地開展病案質量管理提供依據.
목적 분석기의병안산생적원인,위질병상관조(diagnosis related groups,DRGs)전정기출.방법 종2010년지2014년17 751빈수술병안수혈중안조주요진단여주요수술적선택원칙사선출기의병안268빈,채용단인소잡방검험분석불동주원특정대기의병안적영향,장유현저성차이적변량부치후채용Logistic회귀분석심조기의병안산생적영향인소.결과 17 751빈수술환자주원병안수혈중공유기의병안268빈,점전부수술병안적1.51％.Logistic회귀분석결과현시:내과출원、사망환자、전과、고령、주원시간장、종류환자도시도치기의병안산생적위험인소,결과균유통계학의의(P＜0.05),기중출원과별(OR=6.595,95％ CI:5.043～8.625)、시부사망환자(OR=3.787,95％CI:2.611～5.492)화시부전과(OR=2.746,95％CI: 2.061～3.659)시영향기의병안발생솔적중요위험인소.결론 통과대기의병안산생원인적분석,위의원유침대성지개전병안질량관리제공의거.
Objective Analyze the causes of ambiguous medical records to provide evidence for the DRGs.Methods 268 Ambiguous medical records were selected from 17 751 surgery medical records between 2010 and 2014 based on major diagnosis and major surgery.The single factor Chi-square test was used to study the influence of various inpatient characteristics on the occurrence of ambiguous medical records, and those significant variables were given assignment to find influencing factors of ambiguous medical records by using logistic regression analysis.Results Ambiguous medical records account for 1.51％ of all surgical medical records.Logistic regression analysis results show that such risk factors as discharging from internal medicine, death of patient, transfer between departments, elderly, long time of hospitalization, and tumor patients, as contributing to ambiguous medical records.All the results are statistically significant (P＜0.05), including discharging from which departments (OR=6.595, 95％CI..5.043 ～ 8.625), death of patient (OR=3.787, 95％ CI: 2.611 ～ 5.492) and transfer between departments (OR =2.746, 95％ CI: 2.061 ～ 3.659), which rank important risk factors for ambiguous medical records.Conclusion Analysis of the causes of ambiguous medical records provides important evidences for the hospital to improve its medical record quality management.
