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Table 5 Hospital intention profiles based on the 3-factor model

From: DRG coding practice: a nationwide hospital survey in Thailand

Profile

Data Quality

Coding Practice

Reimbursement

Description*

1

X

  

Hospital appoints committees to be responsible for the quality of medical record, discharge summary, as well as diagnosis and procedure codes. The audits are regularly conducted and the findings are used as feedback to improve the quality of medical records, discharge summary, as well as diagnosis and procedure codes.

2

 

X

 

Hospital sets policy and provides essential inputs to ensure good diagnosis and procedure codes. Physicians are considered as the key profession and therefore expected to take responsibility at various levels. Hospital may appoint a physician to oversee the whole hospital coding practice. Physicians at operational level may be required to provide appropriate diagnosis and procedure codes, in addition to their mandated discharge summary task. Medical statisticians are important primarily for checking the codes provided by the physicians and secondarily overseeing the IT aspect of the coding process.

3

  

X

Hospital pays most of its attention on the diagnosis and procedure codes given. The codes are strategically analyzed to see how much relative weight would change across various sets of codes. Selectivity is more obvious when health insurance status of the patient has to be checked before the coding is done.

4

X

X

 

Hospital not only tries to improve coding practice, but also attempts to monitor the quality of medical record, discharge summary, as well as diagnosis and procedure codes.

5

 

X

X

Hospital tries to improve coding practice, but mainly to increase relative weight and therefore reimbursement.

6

X

 

X

Hospital concerns about both data quality and it effects on reimbursement; however, no explicit evidence of coding practice improvement can be found.

7

X

X

X

Hospital shows evidence of improving the coding practice, monitoring the quality of medical record, discharge summary, and diagnosis and procedure codes, as well as checking how the codes affect final reimbursement amount.

8

   

Hospital is in status quo with no interest in monitoring data quality, improving coding practice, or how much reimbursement would be affected.

  1. Note: Each of the profile is described based on the set of items in all factors included in the profile.