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정신건강의학과 환자 입원의료비에 있어 한국형 진단명기준 환자군분류체계의 의미와 한계

Other Titles
 The Significance and Limitations of Korean Diagnosis-Related Groups in Psychiatric Inpatients' Hospital Charges 
 조근호  ;  석정호  ;  정운진  ;  이병철  ;  김애련  ;  최은경  ;  원보윤  ;  이정석 
 Journal of the Korean Neuropsychiatric Association (신경정신의학), Vol.56(1) : 10-19, 2017-02 
Journal Title
 Journal of the Korean Neuropsychiatric Association (신경정신의학) 
Issue Date
Diagnosis-Related Groups ; Hospital charge ; Health Insurance ; Classification of disease
Objectives This study was conducted to investigate whether the charges associated with Korean Diagnosis-Related Groups for mental health inpatients adequately reflect the degree of medical resource consumption for inpatient treatment in the psychiatric ward. Methods This study was conducted with psychiatric inpatients data for 2014 from the National Health Insurance claim database. The main diagnoses required for admission, classification of the hospitals, and main treatment services were analyzed by examining descriptive statistics. Homogeneities of the major diagnostic criteria were assessed by calculating coefficient variances. Explanation power was determined by R2 values. Results The most frequent disorders for psychiatric inpatient treatment were alcohol-use disorder, depressive episodes, bipolar affective disorder, and dementia in Alzheimer's disease. Hospitalization and psychotherapy fees were the main medical expenses. Regardless of the homogeneity of the disease group, duration of hospital stay was the factor that most influenced medical expenses. In the psychiatric area, explanation power of Korean Diagnosis-Related Groups was 16.52% (p<0.05), which was significantly lower than that for other major diagnostic area. Conclusion Most psychiatric illnesses are chronic, and the density of services can vary depending on illness severity or associated complications. The current Korean Diagnosis-Related Groups criteria did not adequately represent the amount of in-hospital medical expenditures. A novel Korean classification system that reflects the expenditures of medical resources in psychiatric hospitals should be developed in order to provide appropriate reimbursements.
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1. College of Medicine (의과대학) > Dept. of Psychiatry (정신과학교실) > 1. Journal Papers
Yonsei Authors
Seok, Jeong Ho(석정호) ORCID logo https://orcid.org/0000-0002-9402-7591
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