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[1]李迪夏家红孙晖舒琴蒋竞孙扬辛艳姣陶红兵徐小兵潘小凯.病案编码质量提升对临床绩效的作用机制研究[J].中国卫生质量管理,2026,33(5):55-59.[doi:10.13912/j.cnki.chqm.2026.33.5.11]
　LI Di,XIA Jiahong,SUN Hui.Research on the Mechanism of the Impact of Improved Medical Record Coding Quality on Clinical Performance[J].Chinese Health Quality Management,2026,33(5):55-59.[doi:10.13912/j.cnki.chqm.2026.33.5.11]

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病案编码质量提升对临床绩效的作用机制研究

《中国卫生质量管理》[ISSN:1006-7515/CN:CN 61-1283/R] 卷: 33 期数: 2026年5期页码: 55-59 栏目: 绩效管理与医院高质量发展出版日期: 2026-05-15

Title:: Research on the Mechanism of the Impact of Improved Medical Record Coding Quality on Clinical Performance

作者:: 李迪夏家红孙晖舒琴蒋竞孙扬辛艳姣陶红兵徐小兵潘小凯; 华中科技大学同济医学院附属协和医院

Author(s):: LI Di; XIA Jiahong; SUN Hui; Union Hospital, Tongji Medical College, Huazhong University of Science and Technology

关键词:: DRG分组; 病案编码; 临床绩效; 精细化管理

Keywords:: DRG Grouping; Medical Record Coding; Clinical Performance; Refined Management

分类号:: R197.323

DOI:: 10.13912/j.cnki.chqm.2026.33.5.11

文献标志码:: A

摘要:: 目的探讨公立医院高质量发展背景下病案编码质量提升对临床绩效的作用机制。方法采用单中心前后自身对照研究设计，选取某大型三甲公立医院2022—2023年的病案首页数据、DRG分组数据及临床绩效指标数据，对比分析编码质量提升前后的关键指标变化，阐释其内在作用机制。结果编码质量提升后，总编码错误率降低2.2百分点，DRG入组率由99.3%提升至99.6%；全院病例组合指数由1.68提升至1.75；平均住院日缩短0.8 d；次均费用下降1 872.4元。结论病案编码准确性是医院实现精细化管理和临床绩效优化的数据基础。本研究揭示了“编码质量提升→DRG分组优化→医院管理响应→临床绩效改善”的链式机制模型，通过提升编码质量赋能医院管理，间接促进了诊疗能力、效率与成本控制效能的协同提升。

Abstract:: ObjectiveTo explore the mechanism by which improved medical record coding quality affects clinical performance in the context of high-quality development of public hospitals.MethodsA single-center, self-controlled before-and-after study design was adopted. Medical record front-page data, diagnosis related groups (DRG) grouping data, and clinical performance indicator data from a large tertiary public hospital during the period from 2022 to 2023 were selected. Key indicators before and after the improvement in coding quality were compared and analyzed to elucidate the underlying mechanism.ResultsAfter the improvement in coding quality, the overall coding error rate decreased by 2.2 percentage points, and the DRG grouping rate increased from 99.3% to 99.6%. The hospital-wide case mix index increased from 1.68 to 1.75. The average length of stay shortened by 0.8 days, and the average cost per admission decreased by 1 872.4 yuan.Conclusion The accuracy of medical record coding serves as the data foundation for refined hospital management and clinical performance optimization. This study reveals a chain mechanism model of "improved coding quality → optimized DRG grouping → hospital management response → improved clinical performance". By enhancing coding quality, hospital management is empowered, indirectly promoting the coordinated improvement of diagnostic and therapeutic capabilities, efficiency, and cost-control effectiveness.

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更新日期/Last Update: 2026-05-15