Release of quality control index of medical record management

The National Health Commission recently issued the “quality control index of medical record management” to further strengthen medical quality management, standardize clinical diagnosis and treatment behavior, and promote the standardization and homogenization of medical services. < / P > < p > the released medical record quality control index system includes human resource allocation index, timeliness index of medical record writing, coincidence rate of major examination records, coincidence rate of diagnosis and treatment behavior records, and quality index of medical record filing. The specific indicators include the number of discharged patients’ medical records, the completion rate of admission records within 24 hours, the correct rate of main operation coding, etc., covering outpatient and inpatient medical records, covering all aspects of medical record management, such as the front page, content and filing of medical records. At the same time, referring to the international practice, the 2021 index clearly defines the definition, calculation formula and significance of the index, complements some indexes and codes them uniformly.