目的分析质控小组审核下对国际疾病分类第10次修订版(international classification of diseases-10,ICD-10)编码准确性的影响。方法选取2021年1月—2022年12月盘州市人民医院病案室编码人员10名为研究对象,2021年1—12月(实施前)开展...目的分析质控小组审核下对国际疾病分类第10次修订版(international classification of diseases-10,ICD-10)编码准确性的影响。方法选取2021年1月—2022年12月盘州市人民医院病案室编码人员10名为研究对象,2021年1—12月(实施前)开展常规管理,2022年1—12月(实施后)则开展质控小组审核下的精细化管理。对精细化管理实施前后的ICD-10编码情况进行观察比较。结果与实施前相比较,实施后的ICD-10编码错误更少,差异均有统计学意义(P均<0.05)。与实施前相比较,实施后的病案管理质量评分均更高,差异均有统计学意义(P均<0.05)。实施前,10名编码人员中,不满意3名,一般满意5名,十分满意2名,满意度为70.00%(7/10);实施后,10名编码人员中,一般满意3名,十分满意7名,满意度为100.00%(10/10)。结论应用质控小组审核下的精细化管理,能减少ICD-10编码错误,而且还能进一步提升ICD-10编码管理的整体质量及病案管理质量、满意度。展开更多
Background:Administrative database provides valuable information for large cohort studies,especially when tissue diagnosis is rather difficult such as the diagnosis for bile duct cancer(BDC).The aim of this study was ...Background:Administrative database provides valuable information for large cohort studies,especially when tissue diagnosis is rather difficult such as the diagnosis for bile duct cancer(BDC).The aim of this study was to evaluate the diagnostic accuracy of administrative database for BDC by International Classification of Diseases(ICD)-10 codes in a tertiary institute.Methods:BDC and control groups were collected from 2003 to 2016 at Seoul National University Bundang Hospital.Cases of BDC were identified in the National Health Insurance Service(NHIS)database by ICD 10-code supported by V code.The control group was selected from cases without ICD-10 codes for BDC.A definite or possible diagnosis was defined according to pathologic reports.Medical records,images,and pathology reports were analyzed to evaluate ICD-10 codes for BDC.Sensitivity,specificity,positive predictive value,and negative predictive value for BDC were analyzed according to diagnostic criteria and cancer locations.Results:A total of 1707 patients with BDC and 1707 controls were collected.Among those with BDC,1320(77.3%)were diagnosed by definite criteria.Most(99.4%)of them had adenocarcinoma.Rate of definite diagnosis was the highest for ampulla of Vater(88.9%),followed by that for extrahepatic(84.9%)and intrahepatic(68.3%)BDCs.False positive cases commonly had hepatocellular carcinomas.For overall diagnosis of BDC,sensitivity,specificity,positive predictive value,and negative predictive value were 99.94%,98.33%,98.30%,and 99.94%,respectively.Diagnostic accuracies were similar regardless of diagnostic criteria or tumor locations.Conclusions:Administrative database for BDC collected according to ICD-10 code with V code shows good accuracy.展开更多
文摘目的分析质控小组审核下对国际疾病分类第10次修订版(international classification of diseases-10,ICD-10)编码准确性的影响。方法选取2021年1月—2022年12月盘州市人民医院病案室编码人员10名为研究对象,2021年1—12月(实施前)开展常规管理,2022年1—12月(实施后)则开展质控小组审核下的精细化管理。对精细化管理实施前后的ICD-10编码情况进行观察比较。结果与实施前相比较,实施后的ICD-10编码错误更少,差异均有统计学意义(P均<0.05)。与实施前相比较,实施后的病案管理质量评分均更高,差异均有统计学意义(P均<0.05)。实施前,10名编码人员中,不满意3名,一般满意5名,十分满意2名,满意度为70.00%(7/10);实施后,10名编码人员中,一般满意3名,十分满意7名,满意度为100.00%(10/10)。结论应用质控小组审核下的精细化管理,能减少ICD-10编码错误,而且还能进一步提升ICD-10编码管理的整体质量及病案管理质量、满意度。
基金a grant from the National Research Foundation of Korea(NRF)(No.2011-0030001)the Global Core Research Center(GCRC)funded by the Korean government(MSIP).
文摘Background:Administrative database provides valuable information for large cohort studies,especially when tissue diagnosis is rather difficult such as the diagnosis for bile duct cancer(BDC).The aim of this study was to evaluate the diagnostic accuracy of administrative database for BDC by International Classification of Diseases(ICD)-10 codes in a tertiary institute.Methods:BDC and control groups were collected from 2003 to 2016 at Seoul National University Bundang Hospital.Cases of BDC were identified in the National Health Insurance Service(NHIS)database by ICD 10-code supported by V code.The control group was selected from cases without ICD-10 codes for BDC.A definite or possible diagnosis was defined according to pathologic reports.Medical records,images,and pathology reports were analyzed to evaluate ICD-10 codes for BDC.Sensitivity,specificity,positive predictive value,and negative predictive value for BDC were analyzed according to diagnostic criteria and cancer locations.Results:A total of 1707 patients with BDC and 1707 controls were collected.Among those with BDC,1320(77.3%)were diagnosed by definite criteria.Most(99.4%)of them had adenocarcinoma.Rate of definite diagnosis was the highest for ampulla of Vater(88.9%),followed by that for extrahepatic(84.9%)and intrahepatic(68.3%)BDCs.False positive cases commonly had hepatocellular carcinomas.For overall diagnosis of BDC,sensitivity,specificity,positive predictive value,and negative predictive value were 99.94%,98.33%,98.30%,and 99.94%,respectively.Diagnostic accuracies were similar regardless of diagnostic criteria or tumor locations.Conclusions:Administrative database for BDC collected according to ICD-10 code with V code shows good accuracy.
