各層級醫院疾病分類人員工作時間和內容之比較

Comparison of Coder's Job at Hospitals of Various Levels in Terms of Working Hours and Job Content

楊美雪(Mei-Hsueh Yang) ； 潘大永(Ta-Yung Pan) ； 范春寶(Chun-Pao Fan) ； 張樹棠(Shu-Tang Chang) ； 葉碧玉(Bih-Yu Yeh)

《病歷資訊管理》 9卷1期 (2009/09) Pp. 68-82

https://doi.org/10.29741/JMHIM.200909.0006

摘要

Objectives: To analyze the current work conditions of coders serving at hospitals of different levels in Taiwan and provide useful data for the hospital to optimize its policy on relevant manpower resource management.
Methods: A self-administered constructive questionnaire was mailed to 621 coders of all accredited hospitals, of regional level and above, nationwide in 2004 to gather needed information. The number of useable responses collected was 347 with a valid return rate of 55.88%. The data process followed included a descriptive statistical analysis, Chi-square test, and ANOVA.
Results: There were no significant differences in weekly working hours at hospitals of different levels. However, the mean workload in terms of case number to deal with in a week in the discharge record category of ICD coding for a coder employed by a medical center, a regional teaching hospital, a regional hospital, a district teaching hospital, or
a district hospital happened to be 167.15±49.53, 135.63±69.10, 158.82±159.94, 112.35±52.96, or 48.65±79.72, respectively. It appears such number of ICD coding, say, at a medical center was significantly higher than that at a district teaching hospital (P＜0.05) or at a district hospital (P＜0.001). The number at a district hosp ital appeared to be significantly fewer than those at hospitals of all other levels studied, e.g. a regional teaching one (P＜0.001), a regional one (P＜0.001), and a district teaching one (P＜0.01) From the study we discovered that a coder was required to carry out 18 routine tasks, such as ICD coding of discharge record, that of outpatient ER, cross review of ICD coding, etc. Aside from those routine coding specialties, a coder also had to be responsible for hospitalization date control and other non-specialty record coding management in dealing with health competent authorities, legal matters, Bureau of Labor Insurance business, and commercial insurance companies.
Conclusions: The job content of a hospital coder in terms of task items was rather similar across the spectrum of hospital levels. However, except the weight of discharge record ICD coding being alike to one another, the variation of the rest items seemed to be quite large. It appears the workload of a coder working for a hospital at the district teaching hospital level or above was simply too heavy to do a good enough job. Thus our recommendation is to increase the number of coders as to reduce her or his workload to improve the coding accuracy and integrity.

關鍵字

疾病分類人員 ； 工作負荷 ； 疾病分類編碼

並列摘要

Objectives: To analyze the current work conditions of coders serving at hospitals of different levels in Taiwan and provide useful data for the hospital to optimize its policy on relevant manpower resource management.
Methods: A self-administered constructive questionnaire was mailed to 621 coders of all accredited hospitals, of regional level and above, nationwide in 2004 to gather needed information. The number of useable responses collected was 347 with a valid return rate of 55.88%. The data process followed included a descriptive statistical analysis, Chi-square test, and ANOVA.
Results: There were no significant differences in weekly working hours at hospitals of different levels. However, the mean workload in terms of case number to deal with in a week in the discharge record category of ICD coding for a coder employed by a medical center, a regional teaching hospital, a regional hospital, a district teaching hospital, or
a district hospital happened to be 167.15±49.53, 135.63±69.10, 158.82±159.94, 112.35±52.96, or 48.65±79.72, respectively. It appears such number of ICD coding, say, at a medical center was significantly higher than that at a district teaching hospital (P＜0.05) or at a district hospital (P＜0.001). The number at a district hosp ital appeared to be significantly fewer than those at hospitals of all other levels studied, e.g. a regional teaching one (P＜0.001), a regional one (P＜0.001), and a district teaching one (P＜0.01) From the study we discovered that a coder was required to carry out 18 routine tasks, such as ICD coding of discharge record, that of outpatient ER, cross review of ICD coding, etc. Aside from those routine coding specialties, a coder also had to be responsible for hospitalization date control and other non-specialty record coding management in dealing with health competent authorities, legal matters, Bureau of Labor Insurance business, and commercial insurance companies.
Conclusions: The job content of a hospital coder in terms of task items was rather similar across the spectrum of hospital levels. However, except the weight of discharge record ICD coding being alike to one another, the variation of the rest items seemed to be quite large. It appears the workload of a coder working for a hospital at the district teaching hospital level or above was simply too heavy to do a good enough job. Thus our recommendation is to increase the number of coders as to reduce her or his workload to improve the coding accuracy and integrity.

並列關鍵字

coder ； workload ； ICD coding