目標：探討專科層級醫管科學生對前瞻性DRGs制度下疾病分類人員所扮演的角色認知類別及影響因素。方法：本研究以國內技職體系專科層級醫務管理科各學制八十八年度應屆畢業生1,652人為研究母群，採分層集群抽樣，抽出821人為研究對象，採用問卷調查法，總共完成780人。結果：本研究顯示在DRGs制度下疾病分類人員所扮演的角色，就學生認知包含有疾病分類編碼依從性評估及管理能力、醫師病歷書寫及疾病分類人員教育訓練的投入與其他病歷相關資料的運用能力等三個構面，且其認知程度會受年齡、學制別、是否在醫院實習過疾病分類工作、疾病分類課程每週上課時數、課程為必修或選修等因素影響。結論：因應未來DRGs制度之實施，優良素質之疾病分類人員為醫療機構不可或缺的人力，故醫療單位應重視人力結構調整及疾病分類專業素質之提昇。此外學生特質（年齡、學制別）及學習過程也是影響學習效果所應考量的因素，故教育單位亦應對未來疾病分類人力培育課程規劃及培育制度之發展重新調整，醫政單位更應就疾病分類人力作妥善規劃。 Objectives：To explore the perceptive dimensions of the coder’s role and identify factors accounted for differences in perceptive competence among junior college would-be graduates of the Department of Hospital and Health Care Administration in vocational technical education as the reimbursement of National Health Insurance program switching to DRGs prospective payment system (DRGs/PPS). Methods：Data were from stratified cluster sampled survey conducted in junior college would-be graduates of the Department of Hospital and Health Care Administration in the school year
1999. A structure questionnaire was distributed to the 821 samples. The survey had an excellent rate response (95.0%). Results ： This study revealed that the coder’s role in terms of would-be graduate’s perception were three dimensions, they were: (1)meeting the coding compliance(coding, clinical, resource) and management competence, (2)commitments of physician’s records documentation and coder’s education, and (3)exerting clinical pertinent documentation. Factors
affecting would-be graduate’s perception on the coder’s role included age, school program (Day school 2 year/5 year; Night school 2 year), field study, course hour and course attribute (required/elective) of Classification of Diseases. Conclusions：As medical care reimbursements became tied to code assignments, physicians and healthcare organizations are now realizing they can not expect minimally trained staff to perform the critical coding and billing functions that today have such an important impact on revenue generation. Besides, student’s characteristics (age、study program) and the process of studying should be taken as important consideration to prepare an eligible coder. We suggested that university/college program should be accountable to nurturing qualified coders for knowledge, skills, and abilities. Additionally, we anticipate the health authority develops a coder’s manpower planning and then improving a coder’s career.
