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.
초록· 키워드
오류제보하기
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.
목차
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참고문헌 (30)
참고문헌 신청
Averill RF / 2011 / 3M APR DRG classification system version 29.0. definitions manual / 3M Health Information Systems
Averill RF / 1999 / The evolution of casemix measurement using diagnosis related groups (DRGs) / 3M Health Information Systems
Busse R / 2011 / Diagnosis-related groups in Europe / Open University Press
Casas M / 1991 / Issues for comparability of DRG statistics in Europe: results from EURODRG / Health Policy 17(2):121~132
Casemix Design Authority / 2009 / The casemix design framework 2009: performance measurement techniques / National Health Service Information Centre
Averill RF / 1999 / The evolution of casemix measurement using diagnosis related groups (DRGs) / 3M Health Information Systems
Busse R / 2011 / Diagnosis-related groups in Europe / Open University Press
Casas M / 1991 / Issues for comparability of DRG statistics in Europe: results from EURODRG / Health Policy 17(2):121~132
Casemix Design Authority / 2009 / The casemix design framework 2009: performance measurement techniques / National Health Service Information Centre
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