摘要
目的了解成都市医保支付改革下编码员现状,为推进编码员队伍建设提供可靠依据。方法2022年4月1日-2022年6月1日,对成都市709家医疗机构病案科编码员的专业背景、继续教育、对临床的交流指导等情况开展实名制电子问卷调查。结果调查709家医疗机构中,三级、二级、二级以下医院平均编码员数量为3.33、1.35、0.64;编码员年人均负担病案数为6603.61、3759.81、3288.46;编码员临床医学专业占12.61%,护理专业占29.67%,医技专业占6.43%,卫生管理专业占21.38%;644家未选派专职人员参加3个月以上脱产进修;83.87%的三级医院,73.58%的二级医院,40.04%的二级以下医院开展编码员院内继续学习,编码员的学习涉及医保知识较少,25.95%的医院病案科未对临床开展ICD交流指导。结论编码员存在专业人员配置不足,背景复杂,知识结构不全,临床交流指导力度不够等问题,建议编码员加强学习,扩展临床知识面,提高编码水平。
ObjectivesTo understand the current situation of coders under medical insurance payment reform in Chengdu,and provide a reliable basis for promoting the construction of coders team.Methods From April 1st,2022 to June 1st,2022,a real-name electronic questionnaire survey was conducted on the professional background,continuing education,and clinical exchange and guidance of coders in medical record departments of 709 medical institutions in Chengdu.Results In the survey of 709 medical institutions,the average number of coders in tertiary,secondary and below secondary hospitals was 3.33,1.35 and 0.64;The average annual burden of medical records of coders was 6603.61,3759.81 and 3288.46.The coders majored in clinical medicine accounted for 12.61%,nursing accounted for 29.67%,medical technology accounted for 6.43%,and health management accounted for 21.38%.644 did not send full-time personnel to attend the off-job training for more than 3 months;83.87%of tertiary hospitals,73.58%of secondary hospitals,and 40.04%of sub-secondary hospitals carried out in-hospital continuing learning for coders.Coders'learning involved little medical insurance knowledge,and 25.95%of medical records departments of hospitals did not carry out ICD communication and guidance for clinical practice.Conclusions Coders had problems such as insufficient professional staffing,complex background,incomplete knowledge structure,and insufficient clinical communication and guidance.It was suggested that coders strengthen the study of medical insurance policy and coding business,expand their clinical knowledge,strengthen clinical communication,improve their professional ethics,and take the initiative to change in dealing with the reform of medical insurance payment,so as to better become coders in the new era.
作者
周磊
陈俐
何莉
曾昭宇
Zhou Lei;Chen Li;He Li;Zeng Zhaoyu(The Third People's Hospital of Chengdu,Chengdu 610014,Sichuan Province,China;不详)
出处
《中国病案》
2023年第8期1-3,共3页
Chinese Medical Record
基金
四川省医院协会医务管理分会课题(SCYW002)
四川省卫生经济学会科研课题(2023SCWJ0027)
四川省卫生信息学会资助项目(2022031)。
关键词
医保改革
编码员
现状
调查
Medical insurance payment reform
Coders
Current situation
Survey
