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의료보험청구자료중 뇌혈관질환 상병기호의 정확도에관한 연구

Other Titles
 The Accuracy of ICD codes for Cerebrovascular Diseases in Medical Insurance Claims 
 박종구  ;  김기순  ;  김춘배  ;  이태용  ;  이강숙  ;  이덕희  ;  이선희  ;  지선하  ;  서 일  ;  고광욱  ;  류소연  ;  박기호  ;  박운제  ;  왕승준  ;  이화순  ;  채유미  ;  홍현숙  ;  서진숙 
 Korean Journal of Preventive Medicine (예방의학회지), Vol.33(1) : 76-82, 2000 
Journal Title
 Korean Journal of Preventive Medicine (예방의학회지) 
Issue Date
Nationwide surveillance system ; Medical insurance claims ; Accuracy ; Cerebrovascular diseases
OBJECTIVES: We attempted to assess the accuracy of ICD codes for cerebrovascular diseases in medical insurance claims (ICMIC) and to investigate the reasons for error. This study was designed as a preliminary study to establish a nationwide surveillance system. METHODS: A total of 626 patients with medical insurance claims who indicated a diagnosis of cerebrovascular diseases during the period from 1993 to 1997 was selected from the Korea Medical Insurance Corporation cohort (KMIC cohort: 115,600 persons). The KMIC cohort was 10% of those insured who had taken health examinations in 1990 and 1992 consecutively. The registered medical record administrators were trained in the survey technique and gathered data from March to May 1999. The definition of cerebrovascular diseases in this study included cases which met one of two criteria (Minnesota, WHO) or 'definite stroke' in CT/MRI finding. We questioned the medical record administrators to explain the error if the final diagnoses were not coded as stroke. RESULTS: The accuracy rate of the ICMIC was 83.0% (425 cases). Medical records were not available for 8.2% (51 cases) due to the closing of hospitals, the absence of a computer system or omission of medical record, etc. Sixty-three cases (10.0%) were classified as impossible to interpret due to insufficient records in 'major clinical symptoms' or 'neurological deficits'. The most common reason was 'to meet review criteria of medical insurance benefits (52.9%)'. The department where errors in the ICMIC occurred most frequently was the department for medical insurance claims in the hospital. CONCLUSION: The accuracy rate of the ICMIC was 83.0%.
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Preventive Medicine and Public Health (예방의학교실) > 1. Journal Papers
4. Graduate School of Public Health (보건대학원) > Graduate School of Public Health (보건대학원) > 1. Journal Papers
Yonsei Authors
Suh, Il(서일) ORCID logo https://orcid.org/0000-0002-9689-7849
Jee, Sun Ha(지선하) ORCID logo https://orcid.org/0000-0001-9519-3068
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