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医院数据质量与疾病诊断相关分组

Quality of hospital data and DRGs.

作者信息

Aas I H

机构信息

Norwegian Institute for Hospital Research, Trondheim.

出版信息

Scand J Soc Med. 1988;16(4):223-6. doi: 10.1177/140349488801600406.

Abstract

Research on and application of DRG is frequently performed with the aid of computerized data. This study has been made to assess the importance of errors in hospital data bases for DRG research, and the financial consequences if DRG is used as a reimbursement system. For the same hospital stays information on the DRG grouping variables has been collected from medical records and a data base. Frequencies of errors in the data base for the DRG grouping variables (principal diagnosis, secondary diagnosis, complications, procedures, age and discharge status of death) and length of stay are given. DRG grouping is performed on the basis of both medical record and data base information. The analysis shows the DRG system to be robust towards errors in the data bases. The procedure used in many countries for testing the US DRG definitions with national data found in data bases is also considered to be robust towards errors. Data quality in the studied data base is sufficient for DRG research purposes. The factors giving the robustness are of a general nature and may also apply to other data bases. Quality of computerized data is a less critical factor for DRG than for other applications of such data. If the present data base had been used in financial connection the errors would have had almost no deteriorating effect on hospital incomes.

摘要

疾病诊断相关分组(DRG)的研究与应用常常借助计算机化数据来开展。本研究旨在评估医院数据库中的错误对于DRG研究的重要性,以及若将DRG用作报销系统所产生的财务后果。针对同一住院病例,从病历和数据库中收集了关于DRG分组变量的信息。给出了DRG分组变量(主要诊断、次要诊断、并发症、手术、年龄和死亡出院状态)数据库中的错误频率以及住院时长。DRG分组是基于病历和数据库信息进行的。分析表明DRG系统对数据库中的错误具有较强的稳健性。许多国家用于依据数据库中的国家数据测试美国DRG定义的程序,对错误也具有较强的稳健性。所研究数据库中的数据质量足以满足DRG研究目的。赋予稳健性的因素具有普遍性,可能也适用于其他数据库。对于DRG而言,计算机化数据的质量不像此类数据的其他应用那样关键。如果将当前数据库用于财务关联,这些错误对医院收入几乎不会产生不利影响。

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