- P-ISSN 1010-0695
- E-ISSN 2288-3339
- Apply for Authority
- P-ISSN1010-0695
- E-ISSN2288-3339
Article Detail
Home > Article Detail
Revision and Evaluation of Korean Outpatient Groups-Korean Medicine
Journal of Korean Medicine / Journal of Korean Medicine, (P)1010-0695; (E)2288-3339
2014, v.35 no.3, pp.93-102
&
(2014). Revision and Evaluation of Korean Outpatient Groups-Korean Medicine. Journal of Korean Medicine, 35(3), 93-102.
- Downloaded
- Viewed
Abstract
Objectives: This study aimed at revising the Korean Out-patient Groups for Korean Medicine (KOPG-OM, version 1.0) based on clinical similarity and resource use, by using the accumulated claims data, and evaluating the validity of the revised classification system. Methods: A clinical specialist panel involving 19 specialists from 8 Korean medicine (KM) specialty areas reviewed the classification tree, diagnosis groups and procedure groups in terms of clinical similarity. Several models of outpatient grouping were formulated, with the validity of each tested based on the R2 coefficient of determination for the treatment costs of all visits. To add age splits, the variances of treatment costs by age groups were also analyzed. These statistical analyses were performed using KM claims data of National Health Insurance from 2010 to 2012. Results: The classification tree designed via panel discussions was used to allocate outpatient cases to 26 diagnosis groups, with cases involving procedures such as acupuncture, moxibustion and cupping, then allocated to 9 procedure groups in each diagnosis group. The cases without procedures were categorized into the visit index - medication group. This process resulted in 298 outpatient groups. The R2 values for treatment costs of all visits ranged from 0.38 to 0.69 depending on the providers' types. Conclusions: The revised model of KOPG-KM has a higher validity for outpatient classification than the current system and can provide better management of the costs of outpatient care in KM.
- keywords
- Korean outpatient groups, patient classification system, Korean medicine
Reference
1
1. Health Insurance Review & Assessment Service. KOPG-OM Classification. 2011; Preface 1-2.
2
2. Health Insurance Review & Assessment Service. KOPG Classification. Version 1.1. 2011; Preface 1-2.
3
3. Health Insurance Review & Assessment Service. T/F Operating Result for Development of KOPG-OM and Computerized Classification Program 2006;14-46.
4
4. Averill RF, Goldfield NI, Wynn ME, McGuire TE, et al. Design of Prospective Payment Patient Classification System for Ambulatory Care. Healthcare Financing Review. 1993 Fall 15(1):71-100.
5
5. Averill RF, Muldoon JH, Vertees JC, Goldfield NI, Mullin RL, Fineran EC, et al. The Evolution of Casemix Measurement Using Diagnosis Related Groups. 3M Health Information System, Wallingford, Connecticut. 1999;5-98.
6
6. Fetter RB, Freeman JL. Diagnosis-related groups: Product Line Management within Hospitals. Academy of Management Review. 1986;11(1):41-54.
7
7. Reid B, Palmer G, Aisbett C. The Performance of Australian DRGs. Australian Health Review. 2000;23(2):20-31.
8
8. Palmer G, Reid B. Evaluation of Performance of Diagnosis-Related Groups and Similar Casemix System; Methodological Issues. Health Services Management Research. 2001;14(2):71-81.
9
9. Park HY, Kang GW, Koh Y. Development of Korean Ambulatory Patient Groups. Korean J. Health Policy & Administration. 2006;16(1):17-40.
10
10. Sanderson HF, Anthony P, Mountney LM. Healthcare Resource Groups Version 2. J. of Public Health Medicine. 1995;17(3):349-354.
11
11. Jurgen S, Emanuel K. Homogeneity of the German Diagnosis-Related Groups. Health Services Management Research. 2010;23(4):154-159.
12
12. Shin YS, Lee YS, Park HY, Yeom YK. Development and Evaluation of Korean Diagnosis Related Groups: Medical service utilization of inpatients. Korean J. of Preventive Medicine. 1993;26(2):293-309.
13
13. Kang KW, Park HY, Shin YS. Refinement and Evaluation of Korean Diagnosis Related Groups. Korean J. of Health policy & Administration. 2004;14(1):122-147.
14
14. Park HY, Park KD, Shin YS. On Feasibility of Ambulatory KDRGs for the Classification of Health Insurance Claims. Korean J. of Health policy & Administration. 2003;13(1):98-115.
- Downloaded
- Viewed
- 0KCI Citations
- 0WOS Citations
Other articles from this issue
- Review Study on Ryodoraku Diagnosis Study Methods
- Korean Medical Care and Education Activity in Uzbekistan - Focusing on the Korea-Uzbekistan Friendship Hospital of Korean Medicine -
- The Relationship between the Use of Korean and Western Medicine in treating Musculoskeletal Disease
- The Analysis of Contents Relevant to Korean Medicine in Elementary School National Textbooks
- A Review on Korean Medicine and Personalized Medicine: Syndrome-based Personalized Medicine on the Basis of Syndrome Differentiation and Treatment
- Exploratory Structural Analysis on Eight Positions for New Formulations in Jingyuequanshu by Network Analysis
- Comparative Study on Biological Activities of Gwakhyangjeonggi-san Decoction According to the Preservation Periods
- Using Ultrasonography in Korean Medicine to Observe Organs and Diseases, and Evidence of its Use.
- Revision and Evaluation of Korean Outpatient Groups-Korean Medicine
- Survey of Demand for Medical Devices in Korean Medicine
- A Review Study on Ryodoraku Diagnosis and Evaluation of Low Back Pain
- Review of International Programs of Chinese Medicine University in China
- Study on the Application of Established Korean Medical Classics in the Korean Pharmaceutical Affairs Act
- A Research of characteristics of left/right pulse wave and blood vessel using Korean medicine pulse diagnosis
- more
Recommanded Articles
This website recommended the use the Chrome browser for journal website.