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The organizational culture of acute care hospital's auditing and monitoring programs as experienced by health information management professionals: A phenomenological study.

机译：健康信息管理专业人员所经历的急诊医院审核和监控计划的组织文化：现象学研究。

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摘要

The fight against health care fraud has been a major issue for Congress over the last several decades, largely due to the fact that fraud results in billions of dollars being lost on an annual basis. The research demonstrates that monies that are desperately needed to restore Medicare's Trust Fund. The primary target of this fight, based on the literature, which is mostly anecdotal in nature, seems to be focused more on acute care hospitals; however, this in no way implies that other providers/entities are exempt from scrutiny. In 2010, the government recovered billions of dollars from the health care industry as a whole; however, the highest netting cases from these efforts were from judgments and settlements with acute care hospitals. This study explored the overall characteristics and organizational culture of acute care hospital's auditing and monitoring programs as experienced by Health Information Management professionals. Auditing and monitoring, which is one of seven components of the Office of Inspector General's compliance program guidance, has been identified as the most important component of a compliance program. The component is the vehicle that can be used to identify, correct and try to prevent fraud from reoccurring. A qualitative descriptive phenomenological design was used to gather interview data using Patton's interview approach. Interviews were tape recorded, transcribed, and analyzed using Giorgi's data analysis five step approach. The end result were themes that provided useful insight into acute care hospitals auditing and monitoring programs as experienced by Health Information Management professionals, as well as the overall organizational culture of acute care hospitals auditing and monitoring programs.
机译：在过去的几十年中，与医疗保健欺诈作斗争一直是国会的主要议题，这主要是由于欺诈导致每年损失数十亿美元这一事实。该研究表明，恢复医疗保险信托基金急需的资金。根据文献，这场斗争的主要目标是自然而然的传闻，它似乎更多地集中在急诊医院。但是，这绝不意味着其他提供商/实体不受审查。 2010年，政府从整个医疗保健行业中收回了数十亿美元；但是，通过这些努力获得的最高收益是来自急诊医院的判决和解决。这项研究探讨了健康信息管理专业人员所经历的急诊医院的审计和监测计划的总体特征和组织文化。审计和监督是监察长办公室合规计划指南的七个组成部分之一，已被确定为合规计划的最重要组成部分。该组件是可用于识别，纠正和尝试防止再次发生欺诈的工具。定性描述现象学设计用于使用Patton的采访方法收集采访数据。使用Giorgi的数据分析五步法对访谈进行录音，转录和分析。最终结果是主题，这些主题提供了对健康信息管理专业人员所经历的急诊医院审核和监控计划的有用见解，以及急诊医院审核和监控计划的整体组织文化。

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  • 作者

    Campbell, Lisa L.;

  • 作者单位

    Capella University.;

  • 授予单位 Capella University.;
  • 学科 Health Sciences Health Care Management.
  • 学位 D.H.A.
  • 年度 2013
  • 页码 135 p.
  • 总页数 135
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

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