Department of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
BMC Health Serv Res. 2011 Oct 31;11:290. doi: 10.1186/1472-6963-11-290.
Diagnosis Related Group (DRG) payment is preferred by healthcare reform in various countries but its implementation in resource-limited countries has not been fully explored.
This study was aimed (1) to compare the characteristics of hospitals in Thailand that were audited with those that were not and (2) to develop a simplified scale to measure hospital coding practice.
A questionnaire survey was conducted of 920 hospitals in the Summary and Coding Audit Database (SCAD hospitals, all of which were audited in 2008 because of suspicious reports of possible DRG miscoding); the questionnaire also included 390 non-SCAD hospitals. The questionnaire asked about general demographics of the hospitals, hospital coding structure and process, and also included a set of 63 opinion-oriented items on the current hospital coding practice. Descriptive statistics and exploratory factor analysis (EFA) were used for data analysis.
SCAD and Non-SCAD hospitals were different in many aspects, especially the number of medical statisticians, experience of medical statisticians and physicians, as well as number of certified coders. Factor analysis revealed a simplified 3-factor, 20-item model to assess hospital coding practice and classify hospital intention.
Hospital providers should not be assumed capable of producing high quality DRG codes, especially in resource-limited settings.
诊断相关分组（DRG）支付方式在各国的医疗改革中受到青睐，但在资源有限的国家，其实施情况尚未得到充分探索。
本研究旨在（1）比较接受审核与未接受审核的泰国医院的特征，（2）开发一种简化的量表来衡量医院编码实践。
对 2008 年因疑似可能存在 DRG 编码错误的可疑报告而接受审核的 920 家综合编码审核数据库（SCAD 医院）中的所有医院进行问卷调查，该问卷还包括 390 家非 SCAD 医院。问卷询问了医院的一般人口统计学特征、医院编码结构和流程，还包括一组 63 个关于当前医院编码实践的意见导向项目。采用描述性统计和探索性因素分析（EFA）进行数据分析。
SCAD 和非 SCAD 医院在许多方面存在差异，尤其是医学统计学家的数量、医学统计学家和医生的经验，以及认证编码员的数量。因子分析显示，一种简化的 3 因素、20 项模型可用于评估医院编码实践并对医院意向进行分类。
不应假设医院有能力生成高质量的 DRG 编码，尤其是在资源有限的环境下。
