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.
Objective To evaluate systematically the effect of antibiotic treatment on ventilator-associated tracheobronchitis (VAT). Methods Pubmed,Web of Science,OVID SP (ACP Journal Club,Cochrane Central Register of Contralled Trials,Embase,Medline),as well as China National Knowledge Infrastructure,China Science and Technology Journal Database,and Wanfang Data were searched for literatures about antibiotic treatment on VAT.The search deadline was March 2016.Meta-analysis was conducted with RevMan 5.3 software. Results A total of 6 studies with 769 patients were included.Among 769 patients,432 patients were treated by antibiotics,and 337 patients in control group were treated without antibiotics.Meta-analysis showed antibiotics treatment significantly reduced incidence of ventilator-associated pneumonia compared with control group [OR=0.27,95%CI (0.17,0.43),P<0.05],and shortened length of ICU stay [MD -1.51,95%CI(-2.04,-0.98),P<0.00001] .There were no significant difference in duration of mechanical ventilation [MD -2.52,95%CI (-6.85,1.81),P=0.25],mortality [OR=0.41,95%CI(0.15,1.14),P=0.09],or drug-resistant bacteria production [OR=0.62,95%CI(0.17,2.19),P>0.05]. Conclusions Antibiotic treatment can reduce incidence of ventilator-associated pneumonia in patients with VAT.Further more high quality randomized controlled trials are needed to assess the effect of antibiotic treatment on VAT.