종합병원 의무기록과 운영현황과 성과에 관한 연구

Abstract

[한글]

의무기록과 운영실태 및 성과를 분석하여 의무기록과 운영의 문제점 파악 및 대안을 모색하기 위해 전국의 종합병원을 대상으로 설문을 실시한 결과 응답병원 105개 병원을 대상으로 분석한 주요 결과는 다음과 같다.

첫째, 병상규모가 클수록 병원장의 의무기록과에 대한 지원정도가 높았으며, 부서장의 교육정도는 대학졸이 많았고 부서장의 의무기록분야 경력이 길었다.

둘째, 병상규모가 클수록 조직상 위치는 진료(지원)부서가 많았으며 의무기록실의 24시간 개방이 적었다.

셋째, 병상규모별 의무기록사가 수행하고 있는 업무수는 500병상 이상 병원이 6.6건으로 500병상 미만 병원 5.1건보다 많았으며 전산화된 업무수는 500병상 이상 병원이 7.5건으로 500병상 미만 병원 4.9건보다 많았다. 보조기사수는 500병상 이상 병원이 1.5명으로

500병상 미만 병원 1.0명보다 많았고 운반시설은 500병상 이상 병원일수록 장비 활용이 많았다.

넷째, 병상규모가 클수록 의무기록부서내 QA 활동은 하고 있는 경우와 내용수가 많았다.

다섯째, 500병상 미만 병원에서 의무기록관리규정이 있는 경우가 관리규정이 없는 경우보다 완성도가 높았고 기타 관리규정이 3개 이상인 경우가 3개 미만인 경우보다 효율성이 높았다. 또한 의무기록사수가 0.9명 이상 일때가 0.9명 미만일 때보다 효율성이 낮았다.

이상과 같이 500병상 이상 병원과 500병상 미만 병원의 의무기록과 운영 현황과 성과를 비교할 수 있었다. 따라서 500병상 미만 병원이 운영성과를 높이기 위해서는 의무기록관리규정이 있고 기타관리규정이 좀더 많아야 하며 의무기록사수가 성과에 영향을 미친다는 것을 알 수 있었다. 이로서 의무기록과 운영에 효율을 기할 수 있다고 보며, 앞으로 점 더 구체적인 운영현황 및 성과를 위한 보다 폭넓은 요인들을 포함한 연구가 필요하다고 하겠다.

[영문]

In order to find solutions to the problems in the workings and the outcomes of the Medical Record Department, 105 general hospitals were researched.

The results acquired were as follows :

First, it was discovered that the larger the hospital the more the medical record department was helped by the hospital's director. Most chiefs were university graduates and had been working in the medical record department for a ling time.

Second, it was found that large scale hospitals were not likely to open 24 hours.

Third, in hospitals with over 500 patient beds the medical record administrator of the medical record departments had an average of 6.6 different duties. This exceeds the average number of duties of medical record administrator in hospitals with less than 500 patient beds, 5.1. Also, while 7.5 duties required the use of a computer in hospital with over 500 beds, only 4.9 duties required the use of a computer in hospitals with less than 500 beds, In additions, there was an average of 1.5 assistants in hospitals with over 500 beds while hospitals with less than 500 beds had only 1.0 assistants. In hospitals with over 500 beds, more chart transport systems were used.

Fourth, as the size of the hospital the medical record department was in increased, the number of QA activities that were conducted also increased.

Fifth, hospitals with less than 500 beds that regulated the workings of the medical record departments were found to work more efficiently than hospitals that had no regulation of the medical record department, Medical record departments with more than 3 regulations on their workings were more efficient than medical record departments with less than 3 regulations. In addition, medical record department with an average of less than 0.9 number of medical record administrator per 100 beds worked more efficiently than medical record departments with an average of more than 0.9 number of medical record administrator per 100 beds.

As mentioned above, the workings and the outcome of the medical record departments of hospitals with more than 500 beds and hospitals with less than 500 beds were compared. As the results show, More other regulations are necessary to raise the efficiency of the medical record departments. Medical record management regulation is also necessary.

Moreover, it was discovered that the number of medical record administrator in the medical record department have a direct effect on the outcome of the workings of the medical record department. The methods mentioned above will make the medical record department work more efficiently. In conclusion, more research in this field is necessary to make the medical record work more efficiently.