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한국형진단명기준환자군 분류체계의 동질성 평가

Other Titles
 Evaluation of the Homogeneity of Korean Diagnosis Related Groups 
Authors
 김형선  ;  이선희  ;  남정모 
Citation
 Korean Journal of Health Policy and Administration, Vol.23(1) : 44-51, 2013 
Journal Title
Korean Journal of Health Policy and Administration(보건행정학회지)
ISSN
 1225-4266 
Issue Date
2013
Keywords
Diagnosis related group ; Homogeneity ; Patient classification
Abstract
Background: This study designed to evaluate the homogeneity of Korean diagnosis related group (KDRG) version 3.4 classification system. Methods: The total 5,921,873 claims data submitted to the Health Insurance Review and Assessment Service during 2010 were used. Both coefficient of variation (CV) and reduction in variance of cost were measured for evaluation. This analysis was divided into before and after trimming outliers at the level of adjacent DRG (ADRG), aged ADRG (AADRG) split by age, and DRG split by complication and comorbidity. Results: At the each three level of ADRG, AADRG, and DRG, there were 38.9%, 38.7%, and 30.0% of which had a CV >100% in the untrimmed data and there were 1.4%, 1.4%, and 1.9% in the trimmed one. Before trimming outliers, ADRGs explained 52.5% of the variability in resource use, AADRGs did 53.1% and DRGs did 57.1%. The additional explanatory power by age and comorbidity and complication (CC) split were 0.6%p and 4.6%p for each, which were statistically significant. After trimming outliers, ADRGs explained 75.2% of the variability in resource use, AADRGs did 75.6%, and DRGs did 77.1%. The additional explanatory power were 0.4%p and 2.0%p for each, which were statistically significant too. Conclusion: The results demonstrated that KDRG showed high homogeneity within groups and performance after trimming outliers. But there were DRGs CV >100% after age or CC split and the most contributing factor to high performance of KDRG was the ADRG rather than age or CC split. Therefore, it is recommended that the efforts for improving clinical homogeneity of KDRG such as review of the hierarchical structure of classification systems and classification variables.
Full Text
http://dx.doi.org/10.4332/KJHPA.2013.23.1.044
Files in This Item:
T201303502.pdf Download
DOI
10.4332/KJHPA.2013.23.1.044
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Preventive Medicine (예방의학교실) > 1. Journal Papers
Yonsei Authors
Nam, Chung Mo(남정모) ORCID logo https://orcid.org/0000-0003-0985-0928
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/88124
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