ObjectiveTo encourage clinicians to code the major diagnosis of diseases, in order to improve the correct rate of disease major diagnosis coding. MethodsWe analyzed the data of major diagnostic codes by clinicians from January 2012 to June 2013. The group leader of the clinical treatment was designated to be responsible for the disease coding. Disease coders introduced knowledge of international classification of diseases to the clinical department according to the different characteristics of disease in each department and communicated with clinicians on the problems of disease coding. Then, we tried to find out whether this method could improve the correct rate of major diagnosis coding of diseases. ResultsThe rate of disease major coding by clinicians of the whole hospital and pilot departments increased from 94.081% to 98.301%. The correct rate of disease major coding decreased from 75.824% to 67.483% and then reached 81.893%. The correct rate of disease major coding of the Department of Hematology was 83.824% in August 2012 and then decreased with the lowest rate of 68.025%; and the correct rate of disease major coding of the Department of Orthopedics increased rapidly and reached 90% in September 2012. ConclusionsThrough the leader of the clinical treatment being responsible for the disease coding and encouraging clinicians to code the main diagnosis of diseases, the accurate of disease major diagnosis coding has improved. Strengthening the communication between clinical and Medical Record Departments can help our hospital improve the quality of disease major diagnosis coding continuously.
【摘要】 目的 观察循膀胱经弹拨法干预亚健康状态方案的疗效及优势，并规范其技术标准，为临床提供安全有效的治疗技术范例。 方法 2009年3月-2010年8月，采用多中心、分层区组随机、平行对照的临床研究方法，选择亚健康状态受试者360例，随机分为传统组、弹拨组、复合组，每组120例。观察受试者干预前后的临床症状积分、血沉、血浆乳酸、全血黏度（切变率分别为1、5、30、200/s）的变化，及有效性和安全性。 结果 共305例完成试验，其中传统组97例，弹拨组102例，复合组106例。弹拨组、复合组的总体疗效与传统组比较差异有统计学意义（Plt;0.05），弹拨组与复合组比较差异无统计学意义（Plt;0.05）。干预后弹拨组、复合组的临床症状积分、血沉、血浆乳酸、全血黏度与传统组比较差异有统计学意义（Plt;0.05）；弹拨组与复合组临床症状积分、血液乳酸全血黏度（切变率分别为1、200/s）差异无统计学意义（Pgt;0.05），血沉、全血黏度（切变率分别为5、30/s）差异有统计学意义（Plt;0.05）。各组各指标干预后前后自身比较差异均有统计学意义（Plt;0.05）。 结论 推拿能有效地改善亚健康状态，复合组疗效最佳，弹拨组其次，传统组较差。循膀胱经弹拨法对亚健康状态的干预有效性较传统推拿更好。【Abstract】 Objective To observe the efficacy and advantages of flicking and poking along bladder channels in intervening sub-health state and regulate the technical standards for clinical treatment techniques, in order to provide safe and effective treatment criteria. Methods Multi-centered, stratified randomized and parallel controlled clinical research methods were adopted in this study. From March 2009 to August 2010, 360 subjects with sub-health status were randomly divided into traditional group, flicking and poking group, and combining group with 120 cases in each group. The changes of clinical symptoms, erythrocyte sedimentation rate, plasma lactate, and whole blood viscosity (shear rates of 1, 5, 30, 200/s) as well as the efficacy and safety were observed. Results A total of 305 patients completed the trial, including 97 in the traditional group, 102 in the flicking and poking group, and 106 in the combining group. The general efficacy for the flicking and poking group and the combining group was significantly different from that for the traditional group (Plt;0.05), while there was no significant difference between the flicking and poking group and the combining group. After the intervention, the clinical symptom score, erythrocyte sedimentation rate, plasma lactate, and whole blood viscosity of the flicking and poking group and the combining group were significantly different from those of the traditional group (Plt;0.05). The clinical symptom score, plasma lactate and whole blood viscosity (shear rates of 1, 200/s) of the flicking and poking group and the combining group were not significantly different (Pgt;0.05), while erythrocyte sedimentation rate, and whole blood viscosity (shear rates of 5, 30/s) between those two groups were significantly different (Plt;0.05). All the above mentioned indexes before and after intervention in each group were statistically different (Plt;0.05). Conclusion Massage can improve the sub-health state, and the combining method has the best efficacy followed by flicking and poking, while traditional method has a poor efficacy. Intervening sub-health state with flicking and poking along bladder channels has a better efficacy than the traditional method of massage.