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A qualitative study of DRG coding practice in hospitals under the Thai Universal Coverage scheme
Krit Pongpirul1, Damian G Walker, Peter J Winch
1Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. kpongpir@jhsph.edu
BMC Health Services Research
|April 12, 2011
Summary
Understanding hospital coding practices in Thailand
Area of Science:
- Health Services Research
- Health Informatics
- Healthcare Management
Background:
- The Thai Universal Coverage health insurance scheme relies on accurate Diagnosis Related Group (DRG)-based payments for inpatient care.
- Quality of diagnosis and procedure coding is critical for reimbursement accuracy.
- Limited understanding exists regarding the specific healthcare professions involved and the coding processes within Thai hospitals.
Purpose of the Study:
- To detail the structure and process of hospital coding in Thailand.
- To identify the roles of key hospital staff in the coding process.
- To explore internal dynamics affecting data quality for reimbursement.
Main Methods:
- Qualitative study using semi-structured interviews.
- Involved 43 participants across 10 hospitals (varying in size, location, and type).
Main Results:
- Hospital coding involves both structural (human resources, IT) and process (discharge to submission) components.
- At least eight healthcare disciplines and seven major steps are involved in coding.
- Five key factors influence coding practice: internal dynamics, management, financial dependency, resources, and external factors.
Conclusions:
- Hospital coding is a complex process with structural and process elements.
- Multiple healthcare professional disciplines contribute to coding accuracy.
- Variability in coding practices across hospitals is influenced by five significant factors.
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