摘要目的 探讨24小时病历归档管理对DRGs入组率及付费情况的影响.方法 采用回顾性调查方法,对北京某三级甲等医院2011年11月18日至2012年5月31日DRGs试点期间,实施24小时病历归档管理前、后,出院病历的24小时病历归档率、48小时病历归档率、DRG入组率和付费情况进行调查,并进行多元线性回归分析.结果 实施24小时病历归档管理后,24小时病历归档率、48小时病历归档率、DRGs入组率和付费率有大幅提高,差异有统计学意义(均P＜0.0001).DRGs付费数量与DRGs入组数量呈正相关(回归系数0.75284,P＜0.0001),DRGs入组数量与24小时病历归档数量呈正相关(回归系数0.44233,P＜0.0001).结论 实施24小时出院病历归档管理后,显著提高了DRGs入组率和付费率,是医院顺利实施DRGs付费的必要条件之一.

abstractsObjective To explore the impacts of 24-hour medical records archiving on the DRGs grouping ratio and payment.Methods Retrospective survey was made in a tertiary hospital in Beijing during its pilot from November 18,2011 to May 31,2012.The study covered such categories as the 24-hour medical records archiving ratio,48-hour medical records archiving ratio,DRG grouping ratio and payment for discharged patients prior to and after the practice of such archiving requirement.The data were subject to a multilinear regression analysis.Results The practice of 24-hour archiving,since in place,has significantly raised the 24-hour ratio,48-hour ratio,DRG grouping ratio and payment ratio,with the differences statistically significant (averaging P＜0.0001).DRGs payment amount is positively correlated to the number of DRGs grouping (regression coefficient 0.75284,P＜0.0001).DRGs grouping amount is positively correlated to the number of 24-hour medical records archiving (regression coefficient 0.44233,P＜0.0001).Conclusion The 24-hour archiving practice has significantly raised DRGs grouping and payment ratio,making it one of requisites for hospitals to successfully carry out DRGs payment system.