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한의 입원환자분류체계의 중증도 분류방안 연구

A Study on the Severity Classification in the KDRG-KM (Korean Diagnosis-Related Groups - Korean Medicine)

  • 류지선 (부산대학교 한의과학연구소) ;
  • 김동수 (한국한의학연구원 표준정책기획팀) ;
  • 이병욱 (동국대학교 한의과대학) ;
  • 김창훈 (부산대학교 의학전문대학원) ;
  • 임병묵 (부산대학교 한의학전문대학원 인문사회의학부)
  • Ryu, Jiseon (Research Institute for Korean Medicine, Pusan National University) ;
  • Kim, Dongsu (Korean Medicine Standards Center, Korea Institute of Oriental Medicine) ;
  • Lee, Byungwook (College of Korean Medicine, Dongguk University) ;
  • Kim, Changhoon (Department of Preventive Medicine, School of Medicine, Pusan National University) ;
  • Lim, Byungmook (Division of Humanities and Social Medicine, School of Korean Medicine, Pusan National University)
  • 투고 : 2017.09.06
  • 심사 : 2017.09.26
  • 발행 : 2017.09.30

초록

Backgrounds: Inpatient Classification System for Korean Medicine (KDRG-KM) was developed and has been applied for monitoring the costs of KM hospitals. Yet severity of patients' condition is not applied in the KDRG-KM. Objectives: This study aimed to develop the severity classification methods for KDRG-KM and assessed the explanation powers of severity adjusted KDRG-KM. Methods: Clinical experts panel was organized based on the recommendations from 12 clinical societies of Korean Medicine. Two expert panel workshops were held to develop the severity classification options, and the Delphi survey was performed to measure CCL(Complexity and Comorbidity Level) scores. Explanation powers were calculated using the inpatient EDI claim data issued by hospitals and clinics in 2012. Results: Two options for severity classification were deduced based on the severity classification principle in the domestic and foreign DRG systems. The option one is to classify severity groups using CCL and PCCL(Patient Clinical Complexity Level) scores, and the option two is to form a severity group with patients who belonged principal diagnosis-secondary diagnosis combinations which prolonged length of stay. All two options enhanced explanation powers less than 1%. For third option, patients who received certain treatments for severe conditions were grouped into severity group. The treatment expense of the severity group was significantly higher than that of other patients groups. Conclusions: Applying the severity classifications using principal diagnosis and secondary diagnoses can advance the KDRG-KM for genuine KM hospitalization. More practically, including patients with procedures for severe conditions in a severity group needs to be considered.

키워드

참고문헌

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