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.
이용수
초록· 키워드
오류제보하기
Background: As most of people in Korea are covered by National Health Insurance (NHI), the disease information collected in NHI provides high availability for health policy. Nevertheless, the validity of disease codes in NHI data has been controversial till now. So we tried to evaluate the validity of them by comparing the NHI claims data with Korean National Hospital Discharge In-depth Injury Survey (KNHDIIS) data. Methods: We compared the NHI patients sample data (2009) with the KNHDIIS data (2009). We selected the inpatient data of KNHDIIS and NHI patients sample. The weighted number of patients from NHI patients sample was 5,551,210 and the number of patients from KNHDIIS was 5,559,874. We classified the disease codes into principal diagnoses and other diagnoses, and we compared as one, two, three unit level. Also we calculated the agreement rate of each of them. Results: In the comparison of principal diagnoses, NHI claims data had more C code than KNHDIIS data did, whereas KNHDIIS data had more Z code than NHI claims data did. In the comparison of other diagnoses, NHI claims data had 2, 3 more codes than KNHDIIS data did. The overall agreement rate at three unit level was 76.5% in principal diagnoses and 46.8% in other diagnoses. Conclusion: Considering the large difference between the two data, the validity of disease codes in NHI Claims data seems to be low. To increase the validity of them, the definite detail coding indicator, the reinforcement of coding education, and the reform of system are needed.
목차
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참고문헌 (15)
참고문헌 신청
김록영 / 2013 / 입원 환자 표본 개발에 관한 연구: 국민건강보험 청구자료를 중심으로 / 보건행정학회지 23(2):152~161
Moon OR / 1992 / Individual variations in the code of the international classification of disease for similar outpatient conditions among general practitioners / Korean J Health Policy Admin 2(1):66~79
Lee GS / 1995 / Diagnosis coding agreement between medical records and medical claim billing data
Shin JY / 1996 / A Comparision study of diagnosis code in both medical records and medical claim bills for same discharge patient : focused on the inpatient 10 frequent diseases / J Eulji Univ 16(1):121~136
Shin E / 1998 / Estimation of disease code accuracy of national medical insurance data and the related factors / Korean J Prev Med 31(3):471~480
Moon OR / 1992 / Individual variations in the code of the international classification of disease for similar outpatient conditions among general practitioners / Korean J Health Policy Admin 2(1):66~79
Lee GS / 1995 / Diagnosis coding agreement between medical records and medical claim billing data
Shin JY / 1996 / A Comparision study of diagnosis code in both medical records and medical claim bills for same discharge patient : focused on the inpatient 10 frequent diseases / J Eulji Univ 16(1):121~136
Shin E / 1998 / Estimation of disease code accuracy of national medical insurance data and the related factors / Korean J Prev Med 31(3):471~480
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