全民健康保險預計於未來實施Tw-DRGs支付方式，屆時醫院為了追求符合Tw-DRGs編碼原則的一致性，避免因主診斷選取錯誤的「編碼低報」，必須建置一套具最佳化Tw-DRGs編碼分派提示弁鉬異U申報人員及疾病分類人員之正確診斷編碼次序，提升編碼決策品質。因此本研究以Web-based來建構系統運作的基礎環境，系統開發使用動態伺服器網頁(ASP)技術與VBScript 來設計程式；伺服端系統資料庫建置於Access 2003，以SQL語言進行資料庫的處理，建置一套Tw-DRGs分派輔助決策系統。本系統具主次診斷碼倒置DRGs分派弁遄A協助判斷主要診斷選取、提供最佳化DRGs、警示、查詢等弁遄A而多筆個案批次試算可提供醫院管理所須資訊。以2005年健保住院病患資料為例，中央健保局編碼系統為黃金標準，結果顯示本系統相對準確率為99.18%。本系統之優點為具成本效益且又有網路之可近性高且便於資料收集之特色，有助於健保申報及管理資料之收集 A prospective payment system for National Health Insurance will be introduced based on the classification of the "Taiwan diagnosis-related groups" (Tw-DRGs) in Taiwan. For according with consistency of Tw-DRGs coding principles and diagnosis sequence, the hospital have to establish a Tw-DRGs assignment decision support system with optimization to help coders and claimers to make the right decision about principal diagnosis selection and advance coding decision quality. This study attempted to develop a web-based DRGs assignment decision support system with Active Server Pages (ASP) technologies and Visual Basic Script language (VBScript) programming. Related data of Tw-DRGs were manipulated by SQL query languages in Access 2003 database. The functions of resequencing on principal and secondary diagnosis provided principal diagnosis selection, warning messages, and the query. Compared with Tw-DRGs 7.1 version released by the Bureau of National Health Insurance for the assignment of DRGs, this system demonstrated a relative accuracy of 99.18%. This web-based system was cost-effective as well as highly accessible and convenient for administrative data collection.
