Quality of Inpatient Records Related to Diagnosis Related Group in Changwat Kamphaengphet - คุณภาพเวชระเบียนผู้ป่วยในเพื่อใช้ในการจัดทำกลุ่มวินิจฉัยโรคร่วมโรงพยาบาลในจังหวัดกําแพงเพชร พ.ศ. 2547

Abstract

           Diagnosis Related Group (DRG) reflects nature and severity of the illness. There are several important variables in the DRG including principle diagnosis, co-morbidity, complication, age, procedure, length of stay, discharge status and expenditure. All variables are used for calculating the final standard value, named Relative Weight (RW) and used as a mechanism for inpatient payment system. DRG was initiated in the USA and introduced to Thailand in 1998 for resource allocation in the Low Income Card Scheme. Then, the DRG has been developed to be an important mechanism for inpatient payment system in the Universal Coverage Scheme (UC) since 2002. This descriptive study was aimed at checking out the pitfalls of coding individual inpatient record. The findings were being used for standardizing the inpatient payment in Kamphaengphet province. The study included inpatient data ranging from October 2003 to February 2004. By using systematic random sampling technique, 468 inpatients from every hospital in Kamphaengphet province were included and checked by trained experts. The result of the study showed that there were 446 inpatients, about 95.3 percent, with RW less than 4 (RW <4) while the rest 22 inpatient, about 4.7 percent, had RW equal or more than 4 (RW ≥4). The analysis indicated that the errors found resulting in 50.21 percent change of the DRG grouping and the length of stay should have reduced relative weight by 5.17 percent. In addition, the principle diagnosis had been miscoded in 48.08 percent of the samples. However the quality of the medical and nursing records were not satisfactory. The highest score of the hospitals reached only 74.07 percent and the lowest 40.74 percent. Four of the hospital (36.36%) could not score above 50 percent.