ACOMS+ 및 학술지 리포지터리 설명회

  • 한국과학기술정보연구원(KISTI) 서울분원 대회의실(별관 3층)
  • 2024년 07월 03일(수) 13:30
사전등록 바로가기
 

논문 상세

Home > 논문 상세
  • P-ISSN 1010-0695
  • E-ISSN 2288-3339

이전

다음

37권 3호
Share

한의 입원환자분류체계의 적정성 평가

Assessment of Validity of Inpatient Classification System in Korean Medicine (KDRG-KM)

대한한의학회지 / Journal of Korean Medicine, (P)1010-0695; (E)2288-3339
2016, v.37 no.3, pp.112-122
김동수 (한국한의학연구원)
류지선 (부산대학교)
이병욱 (동국대학교)
임병묵 (부산대학교)
김동수, 류지선, 이병욱, & 임병묵. (2016). 한의 입원환자분류체계의 적정성 평가. 대한한의학회지, 37(3), 112-122.
  • 다운로드 수
  • 조회수

Abstract

Objectives: This study aimed to assess the validity of ‘Korean Diagnosis Related Groups-Korean Medicine (KDRG-KM)’which was developed by Health Insurance Review & Assessment Service (HIRA) in 2013 Methods: Among inpatient EDI claim data issued by hospitals and clinics in 2012, the data which included Korean medicine procedures were selected and analyzed. We selected control targets in the Korean medicine hospitals which had longer Episodes-Costliness index (ECI) and Lengthiness index (LI) than average of total Korean medicine hospitals, and compared the results of selection between the major diagnosis-based patient classification system and the KDRG-KM system. Finally, the explanation power (R2) and coefficient of variation (CV) of the KDRG-KM system using practice expenses were calculated. Results: The numbers of control target in Korean medicine hospitals changed from 36 to 32 when patient grouping adjustment method was changed from major diagnosis to KDRG-KM. For expenses of all outpatient claim data on Korean medicine, explanation power of KDRG-KM system was 66.48% after excluding outliers. CVs of expenses of patient groups in Korean medicine hospitals were gathered from under 70% to under 90%, and those in long-term care hospitals mostly belonged under 70%. Conclusions: The validity of KDRG-KM system was assured in terms of explanation power. By adapting KDRG-KM system, fairness of control targets selection for costliness management in Korean medicine hospitals can be enhanced.

keywords
Patient classification system, Diagnosis related groups, Korean Medicine, explanation power, Costliness index, Lengthiness index


참고문헌

1

1. Kang GW, Lee EJ, Jeon YH, Kang MS, Choi MJ. Basic study for the revision of patient classification system. Health insurance review & assessment service. 2012.

2

2. Health insurance review & assessment service. KOPG-OM classification book. 2011.

3

3. Health insurance review & assessment service. Classification process of Korean medicine patient classification system. Meeting materials for 2016 1st Korean medicine patient classification system review committee. 2016.

4

4. Health insurance review & assessment service. Korean medicine hospital EDI claims data file. 2012.

5

5. Kang GW, Park HY, Shin YS. Refinement and evaluation of Korean diagnosis related groups. Health Policy and Management. 2004;14(1):122-147

6

6. Thomas JW, Ashcraft MLF. Measuring severity of illness: Case severity systems and their ability to explain cost variations. Inquiry. 1991;28:39-55

7

7. Averill RF, Muldoon JH. Vertrees JC, Goldfield NI, et al. The evolution of casemix measurement using DRGs. 3M HIS Sorking Paper. 1997:5-98.

8

8. Palmer G, Reid B. Evaluation of the performance of diagnosis-related groups and similar casemix systems: methodoldgical issues. Health services Management Research. 2001;14:71-81

9

9. Kim HS, Lee SH, Nam JM. Evaluation of the homogeneity of Korean diagnosis related groups. Health Policy and Management. 2013;23(1):44-51

10

10. Shin YS, Lee YS, Park HY, Yeom YK. Development and evaluation of Korea diagnosis related groups: medical service utilization of inpatients. Korean Journal of Preventive Medicine. 2003;26(2):293-309

11

11. Wynn BO. Understanding Medicare severity -DRGs. Santa Monica(CA):RAND. 2007.

  • 다운로드 수
  • 조회수
  • 0KCI 피인용수
  • 0WOS 피인용수

권호 내 다른 논문

추천 논문

상단으로 이동

권호 목록

소개

규정 및 지침

게시판

대한한의학회지

  학술지 홈페이지 이용 환경은   크롬 브라우저 사용을 권장합니다.

대한한의학회지

논문 투고 OA 정책