지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2016.9
- 수록면
- 112 - 122 (11page)
이용수
초록· 키워드
오류제보하기
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.
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.
목차
서론
연구방법
연구결과
고찰
결론
참고문헌
참고문헌 (11)
참고문헌 신청
[학술지(정기간행물)] - Kang GW / 2012 / Basic study for the revision of patient classification system / Health insurance review & assessment service
[기타자료] - Health insurance review & assessment service / 2011 / KOPG-OM classification book
[학술대회논문] - Health insurance review & assessment service / 2016 / Classification process of Korean medicine patient classification system / Meeting materials for 2016 1st Korean medicine patient classification system review committee
[기타자료] - Health insurance review & assessment service / 2012 / Korean medicine hospital EDI claims data file
[학술지(정기간행물)] - 강길원 / 2004 / 한국형진단명기준환자군의 개선과 평가 / 보건행정학회지 14 (1) : 121 ~ 147
[기타자료] - Health insurance review & assessment service / 2011 / KOPG-OM classification book
[학술대회논문] - Health insurance review & assessment service / 2016 / Classification process of Korean medicine patient classification system / Meeting materials for 2016 1st Korean medicine patient classification system review committee
[기타자료] - Health insurance review & assessment service / 2012 / Korean medicine hospital EDI claims data file
[학술지(정기간행물)] - 강길원 / 2004 / 한국형진단명기준환자군의 개선과 평가 / 보건행정학회지 14 (1) : 121 ~ 147
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UCI(KEPA) : I410-ECN-0101-2017-519-001862592