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  • 한국과학기술정보연구원(KISTI) 서울분원 대회의실(별관 3층)
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  • P-ISSN 1010-0695
  • E-ISSN 2288-3339

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한의 입원환자분류체계의 중증도 분류방안 연구

A Study on the Severity Classification in the KDRG-KM (Korean Diagnosis-Related Groups – Korean Medicine)

대한한의학회지 / Journal of Korean Medicine, (P)1010-0695; (E)2288-3339
2017, v.38 no.3, pp.185-196
https://doi.org/10.13048/jkm.17035
류지선 (부산대학교)
김동수 (한국한의학연구원)
이병욱 (동국대학교)
김창훈 (부산대학교 의학전문대학원)
임병묵 (부산대학교)
류지선, 김동수, 이병욱, 김창훈, & 임병묵. (2017). 한의 입원환자분류체계의 중증도 분류방안 연구. 대한한의학회지, 38(3), 185-196, https://doi.org/10.13048/jkm.17035
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Abstract

Backgrounds: Inpatient Classification System for Korean Medicine (KDRG-KM) was developed and has been applied for monitoring the costs of KM hospitals. Yet severity of patients’ condition is not applied in the KDRG-KM. Objectives: This study aimed to develop the severity classification methods for KDRG-KM and assessed the explanation powers of severity adjusted KDRG-KM. Methods: Clinical experts panel was organized based on the recommendations from 12 clinical societies of Korean Medicine. Two expert panel workshops were held to develop the severity classification options, and the Delphi survey was performed to measure CCL(Complexity and Comorbidity Level) scores. Explanation powers were calculated using the inpatient EDI claim data issued by hospitals and clinics in 2012. Results: Two options for severity classification were deduced based on the severity classification principle in the domestic and foreign DRG systems. The option one is to classify severity groups using CCL and PCCL(Patient Clinical Complexity Level) scores, and the option two is to form a severity group with patients who belonged principal diagnosis-secondary diagnosis combinations which prolonged length of stay. All two options enhanced explanation powers less than 1%. For third option, patients who received certain treatments for severe conditions were grouped into severity group. The treatment expense of the severity group was significantly higher than that of other patients groups. Conclusions: Applying the severity classifications using principal diagnosis and secondary diagnoses can advance the KDRG-KM for genuine KM hospitalization. More practically, including patients with procedures for severe conditions in a severity group needs to be considered.

keywords
KDRG-KM, Diagnosis-Related Groups, patient classification system, Korean Medicine, severity classification, CCL


참고문헌

1

1. Health Insurance Review & Assessment Service. Guidebook for KDRG-KM (PDF format). 2017

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2. Kim DS, Ryu JS, Lee BW, Lim BM. Assessment of Validity of Inpatient Classification System in Korean Medicine (KDRG-KM). J Korean Med. 2016;37(3):112-122. http://dx.doi. org/10.13048/jkm.16039

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3. Busse R, Geissler A, Quentin W, Wiley M. Diagnosis-Related Groups in Europe. 2011.

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4. Health Insurance Review & Assessment Service. Evaluation of treatment results - Understanding the adjustment of severity level (Jinryo Gyelgwa Pyunga – Joongjeungdo Bojeongui Yihae) . 2012.

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5. Health Insurance Review & Assessment Service. Korean Medicine hospital EDI claims data file. 2012.

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

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7. Health Insurance Review & Assessment Service. KDRG classification book; version 3.5. 2014.

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8. Kang GW, Lee EJ, Jeon YH, Kang MS, Choi MJ. The basic study on the revision of patient classification system (Hwanja Bunryuchegye Gaejeongeul wihan Gichoyeongu). Final report for Health Insurance Review & Assessment Service. 2012

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9. Gu SJ. Analysis of specialized diseases in pre-post pilot program for Korean Medicine special hospital (Hanbang Jeonmoonbyeongwon Sibeomsaup Silsi Jeonhoo Jeonmoonjilhwan Uiryoyiyong Boonseok)[Master dissertation]. Seoul:Yonsei University; 2009.

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