Browse > Article
http://dx.doi.org/10.14400/JDC.2015.13.12.245

A Convergence Study in the Severity-adjusted Mortality Ratio on inpatients with multiple chronic conditions  

Seo, Young-Suk (Dept. of Health Policy & Management, Inje University)
Kang, Sung-Hong (Dept. of Health Policy & Management, Inje University)
Publication Information
Journal of Digital Convergence / v.13, no.12, 2015 , pp. 245-257 More about this Journal
Abstract
This study was to develop the predictive model for severity-adjusted mortality of inpatients with multiple chronic conditions and analyse the factors on the variation of hospital standardized mortality ratio(HSMR) to propose the plan to reduce the variation. We collect the data "Korean National Hospital Discharge In-depth Injury Survey" from 2008 to 2010 and select the final 110,700 objects of study who have chronic diseases for principal diagnosis and who are over the age of 30 with more than 2 chronic diseases including principal diagnosis. We designed a severity-adjusted mortality predictive model with using data-mining methods (logistic regression analysis, decision tree and neural network method). In this study, we used the predictive model for severity-adjusted mortality ratio by the decision tree using Elixhauser comorbidity index. As the result of the hospital standardized mortality ratio(HSMR) of inpatients with multiple chronic conditions, there were statistically significant differences in HSMR by the insurance type, bed number of hospital, and the location of hospital. We should find the method based on the result of this study to manage mortality ratio of inpatients with multiple chronic conditions efficiently as the national level. So we should make an effort to increase the quality of medical treatment for inpatients with multiple chronic diseases and to reduce growing medical expenses.
Keywords
Multiple Chronic Conditions; Comorbidity Index; Hospital Standardized Mortality Ratio(HSMR); Korean National Hospital Discharge In-depth Injury Survey; Convergency study;
Citations & Related Records
Times Cited By KSCI : 12  (Citation Analysis)
연도 인용수 순위
1 Eun-Kyung Kwak, Utilization of health care services among with multimorbid ambulatory patients. graduate school of Public health, Seoul National University, Master's thesis, 2012.
2 Young-Ho Jeong, Issues and policy Directions of Healthcare Delivery System, Korea Institute for Health and Social Affairs, 2013.
3 Young-Ho Jeong, Suk-Ja Ko, Eun-Ju Kim, A study on the effective chronic disease management, Korea Institute for Health and Social Affairs, 2013.
4 Lisa Miller, Daryl May, Patient choice in the NHS - How critical are facilities services in influencing patient choice, Facilities, 24(9/10), pp. 354-364, 2006.   DOI
5 Institute for Healthcare Improvement, Move Your Dot-Measuring, evaluating, and reducing hospital mortality rates(Part 1). IHI, 2003.
6 Health Insurance Review & Assessment Service, Institute of Health Policy and Management, Seoul National University Medical Research Center, A Study on the ways of the improvement for Quality assessment service, 2010.
7 Jong-Ho Park, Yoo-Mi Kim, Sung-Soo Kim, Won-Joong Kim, Sung-Hong Kang, Comparison of Hospital Standardized Mortality Ratio Using National Hospital Discharge Injury Data, Journal of the Korea Academia-Industrial cooperation Society, 13(4), pp. 1739-1750, 2012.   DOI
8 Canadian Institute for Health Information, HSMR : A New Approach for Measuring Hospital Mortality Trend in Canada, 2007.
9 Won-Joong Kim, Sung-Soo Kim, Eun-Ju Kim, Sung-Hong Kang, Severity-Adjusted LOS Model of AMI patients based on the Korean National Hospital Discharge in-depth Injury Survey Data. Journal of the Korea Academia-Industrial cooperation Society, 14(10), pp. 4910-4918, 2013.   DOI
10 Hee-Sun Choi, Ji-Hye Lim, Won-Joong Kim, Sung-Hong Kang, The effective management of length of stay for patients with acute myocardial infarction in the era of digital hospital, The Journal of Digital Policy & Management, 10(1), pp. 413-422, 2012.
11 Tae-Kyoung Chung, Sung-Hong Kang, The Comparison of Risk-adjusted Mortality Rate between Korea and United States. The Journal of Digital Policy & Management, 11(2), pp. 413-422, 2013.
12 Eun-Jung Lee, Development of Hospital Standardized Mortality Ratio Index Using Administrative Data, Graduate School of Medicine Seoul University, doctor's thesis, 2011.
13 Aylin P, Bottle A, Jen MH, Middleton S, Thechnicla document: HSMR mortality indicators, 2010.
14 Ji-Hye Lim, Mun-Hee Nam, Development of Mortality Model of Severity-Adjustment Method of AMI Patients, Journal of the Korea Academia-Industrial cooperation Society, 13(6), pp. 2672-2679, 2012.   DOI
15 Sung-Hong Kang, Hyang-Sook Seok, Won-Joong Kim, The Variation of Factors of severity-adjusted length of stay(LOS) in acute stroke patients, The Journal of Digital Policy & Management, 11(6), pp. 221-233, 2013.
16 Kyoung-Hoon Kim, Comparative Study on Three Algorithms of the ICD-10 Charlson Comorbidity Index with Myocardial Infarction Patients, Journal of Preventive Medicine and Public Health January, 43(1), pp. 42-49, 2010.   DOI
17 Kyoung-Hoon Kim, Lee-Su Ahn, A Comparative Study on Comorbidity Measurements with Lookback Period using Health Insurance Database: Focused on Patients Who Underwent Percutaneous Coronary Intervention, Journal of Preventive Medicine and Public Health, 42(4), pp. 267-273, 2009.   DOI
18 Canadian Institute for Health Information, HSMR : A New Approach for Measuring Hospital Mortality Trend in Canada, 2007.
19 Se-Won Kim, Seok-Jun Yoon, Min-Ho Kyung, Health Outcome Prediction Using the Charlson Comorbidity Index In Lung Cancer Patients, Korean Journal of Health Policy & Administration 19(4), pp. 18-32, 2009.   DOI
20 Kyoung-Hoon Kim, Comparative Study on Three Algorithms of the ICD-10 Charlson Comorbidity Index with Myocardial Infarction Patients, Journal of Preventive Medicine and Public Health January, 43(1), pp. 42-49, 2010.   DOI
21 Ji-Hye Lim, Jae-Yong Pak, The impact of comorbidity (the Charlson Comorbidity Index) on the health outcomes of patients with the acute myocardial infarction(AMI), Korean Journal of Health Policy & Administration, 21(4), pp. 493-516, 2011.   DOI
22 Young-Euy Kim, Predictive modeling for the risk-adjusted mortality rate of inpatients with acute strokes and the length of their hospital stay, graduate school of Public health, Korea University, Master's thesis, 2013.
23 Chul-Hwan Kang, Yong-Ik Kim, Eun-Jung Lee, The variation in risk adjusted mortality of intensive care units. Korean Journal Anesthesiol, 57(6), pp. 698-703, 2009.   DOI