醫療機構國際疾病分類系統第十版轉換之關鍵障礙與成功因素探討

疾病分類在健康醫療照護體系扮演重要功能，國際疾病分類系統(ICD-10-CM/PCS)於世界衛生組織與歐美先進國家正式啟動，台灣自民國99年開始推動 5年導入計畫，期能正確地反映出當今的醫療技術、醫療處置，與世界接軌，進行相關的統計資料分享及研究。本研究旨在探討系統轉換之關鍵障礙與成功因素探討。本研究以質性研究深度訪談方式執行，立意取樣目前於醫療機構從事編碼工作之人員，資料蒐集至資料飽和，共訪談10位。資料經來探討本研究之主題，並透過研究整理歸類之資料，成為本研究之結論，研究採不記名方式，訪談過程當中，並不蒐集可辨識之個人資訊，研究者在和受訪者訪談前，皆經由受訪者同意後方執行。研究結果發現，進行ICD-9轉換ICD-10關鍵障礙依其重要性分別為資訊設施、人員配合、病歷內容完整度、與資金與經費。而成功因素依序為完善與穩定性高的設備、足夠的經費、良好的團隊溝通、病歷完整度、與管理者的支持。基於以上結果，醫療機構主管，能運用良好的有效溝通，並辦理在職教育，增進團隊溝通與合作，並提撥適當資金建置有效之資訊設施，已臻成功轉換系統之任務。另建議主管機關，於政策制定時，應有不同的配套措施，視機構等級與規模不同，以不同之方式輔導與獎勵方案輔導，藉以加速系統成功轉換之效果。

關鍵字

國際疾病分類系統

並列摘要

Classification of diseases is crucial in health and medical care systems. The International Classification of Diseases (ICD-10-CM/PCS) has been implemented by the World Health Organization and in advanced countries in Europe and North America. Taiwan implemented a 5-year induction program in 2010 to accurately reflect current treatment techniques and medical procedures, integrate with the global community, share related statistical data, and engage in related research. This study explores the critical barriers and key success factors for system transition. Purposive sampling was used to recruit participants engaged in coding tasks in medical institutions. Data was collected till saturation. Qualitative in-depth interviews with 10 participants were conducted. The collected data explored the research topic and the data obtained following analyses formed the research conclusion. The interviewees were maintained anonymous during the interviews, and identifiable personal information relating to the participants was not collected. The interviews were conducted after obtaining the participants’ consent. The results show that the key barriers in the transition from ICD-9 to ICD-10 were, according to their importance, information technology facilities, personnel cooperation, completeness of medical record content, and capital and funding. The key success factors were comprehensive and highly stable equipment, ample funding, favorable team communication, completeness of medical record, and managerial support. According to the results, we infer that managerial personnel in medical institutions had been able to succeed in system transition because they employed effective communication, arranged in-service education, enhanced team communication and cooperation, and reserved sufficient funding for installing effective information technology equipment. This study suggests managerial divisions should counsel and provide incentives for institutions according to the level and scale of the institution, as well as provide different supporting measures accordingly during policy formulations. Such measures will accelerate the effects of a successful system transition.

並列關鍵字

International classification of diseases ； ICD-9 ； ICD-10

參考文獻

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醫療機構國際疾病分類系統第十版轉換之關鍵障礙與成功因素探討

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