• 보건행정학회지
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• 제2권1호
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• pp.66-79
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• 1992

The code of the International Classification of Disease(ICD) is seriously questioned on its effectiveness in identifing an independent disease entity from similar conditions at general practitioner's offices. This study has attempted to show individual coding variations in ICD for similar ambulatory care conditions. It has been assumed that a following outpatient visit is regarded as the sane kind of visit owing to the same disease if a visit to the different source of care would be mad within an interval of less than two days. The 'D' health insurance association was selected for this analysis. The 'D' association had 153,298 members and made claims of 642,605 outpatient care in 1990. Out of the total outpatient claims, 8.6%(55,102 claims) were counted as the same disease which could meet the above assumption. Percent of conditions classified as the 10 leading causes of frequent visits which were matched accurately to the subsequent ICD diagnostic code found to be 15.8% on the average. The URI was noted for the highest concurrence rate of 20.4%. This proportion was even decreased to 11.6% on the case of chronic disease. Despite the fact that the assumption underlying the definition of the above same disease is rather rough and inappropriate, this study reveals that the code of ICD currently in use has weaknesses in seperating a certain independent disease from similar conditions at the outpatient setting. Thus, efforts need to be elaborated to meet the need of a new system of classification for conditions and diseases encountering at ambulatory care.

• 동의생리병리학회지
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• 제22권4호
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• pp.718-724
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• 2008

In order to classify diseases of oriental medicine in liaison with International Classification of Diseases, there should be intermediation and sharing concepts between the two in addition to proper classification. Classification units were settled for differentiation of diseases or syndromes first. And second, the standard forms of disease classification system were proposed. Third, this classification system was made of serial groupings of syndrome under the traditional disease name. Fourth, the location of disease and the interrelation between different syndromes were depicted with diagram in order to define more clearly. As the results and conclusion, The classification units were composed of 2 categories; topology, organ, meridian, somatic structure, body fluid units for description and various regulatory unit terms of western and traditional medicine for explanation. The mixed classification model of western diseases and traditional syndromes(證) was adopted as a fundamental classification system containing disease by exterior pathogen, systemic internal diseases, psychoneuronal diseases, metabolic diseases, diseases of sense organs, supportive structure diseases, obstetric-gynecology diseases, child diseases, 4-type constitutional diseases. And those were differentiated with generalized, localized, functional, oncogenic, environmental features in detail. The cause, site, condition, dispositions must be expressed in each disease name too. The types of diagnosis using classification system are principal and final diagnosis, principal procedure, main conditions, and these are applied to this Korean classification system equally. For more clarification of differentiation, a plane topological map and three dimensional coordinates were proposed to manifest the location, features and relation of disease itself or each other.

• Journal of Digestive Cancer Research
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• 제9권2호
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• pp.57-59
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• 2021

Carcinoid tumor is called as neuroendocrine tumor and is classified into neuroendocrine tumor Grade 1, neuroendocrine tumor Grade 2, and neuroendocrine carcinoma based on the differentiation of tumors. Recently, the incidence of rectal carcinoid tumor has been increasing probably due to the increased interest on screening colonoscopy and the advancement of endoscopic imaging technology. As the rectal carcinoid shows a wide range of clinical characteristics such as metastasis and long-term prognosis depending on the size and histologic features, it is a challenge to give a consistent diagnostic code in patients with the rectal carcinoid. If the rectal carcinoid tumor is less than 1 cm in size, it can be given as the code of definite malignancy or the code of uncertain malignant potential according to International Classification of Diseases for Oncology (ICD-O) by World Health Organization (WHO). Because patients get different amount of benefit from the insurance company based on different diagnostic codes, this inconsistent coding system has caused a significant confusion in the clinical practice. In 2019, WHO updated ICD-O and Statistics Korea subsequently changed Korean Standard Classification of Diseases (KCD) including the code of rectal carcinoid tumors. This review will summarize what has been changed in recent ICD-O and KCD system regarding the rectal carcinoid tumor and surmise its clinical implication.

• 대한한방내과학회지
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• 제31권1호
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• pp.1-10
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• 2010

Objectives : It is necessary that the international classification of diseases (ICD) be examined in order to comprise the third revision of the Korean Classification of Disease on Oriental Medicine (KCD-OM) and disease classification in the oriental internal medicine field. It is essential that the selection, classification and definition of disease and pattern names of oriental concepts in internal medicine be clear. Since 2008, the fifth revision of the Korean Classification of Disease (KCD-5) has been used in Korea. It was required to use the reference classification from the Oriental medicine area based on the ICD-10. Methods : In this review, the necessity for, meaning of and content of the third revision are briefly described. The ICD system was reviewed and KCD-OM was reconstructed. How diagnosis in the oriental internal medicine area had changed is discussed. Review and Results : In 1973, the disease classification of oriental medicine was established the basis on the contents of Dongeuibogam. It was irrespective of the ICD. As to the classification system in the Oriental internal medicine field, systemic disease was comprised of wind, cold, warm, wet, dryness, heat, spirit, ki, blood, phlegm and retained fluid, consumptive disease, etc. Diseases of internal medicine comprised a system according to the five viscera and the six internal organs and followed the classification system of Dongeuibogam. The first and second revisions were of the classification system based on the curriculum in 1979 and 1995. In 1979, in the first revision, geriatric disease and idiopathic types of disease were deleted, and skin disease was included among surgery diseases. This classification was expanded to 792 small classification items and 1,535 detailed classification items to the dozen disease classes. In 1995, in the second revision, it was adjusted to 644 small classes and 1,784 detailed classification items in the dozen disease classes. KCD-OM3 did KCD from this basis. It added and comprised the oriental medical doctor's concept names of diseases considering the special conditions in Korea. KCD-OM3 examined the KCD-OMsecond revised edition (1994). It improved the duplex classification, improper classifications, etc. It is difficult for us to separate the disease names and pattern names in oriental medicine. We added to the U code and made one classification system. By considering the special conditions in Korea, 169 codes (83 disease name codes, 86 pattern name codes) became the pre-existence classification and links among 306 U codes of KCD-OM3. 137 codes were newly added in the third revision. U code added 3 domains. These are composed of the disease name (U20-U33, 97 codes), the disease pattern name (U50-U79, 191 codes) and the constitution pattern name of each disease (U95-U98, 18 codes). Conclusion : The introduction of KCD-OM3 conforms to the diagnostic system by which oriental medical doctors examine classes used with the basic structure of the reference classification of WHO and raises the clinical study and academic activity of the Korean oriental medicine and makes the production of all kinds of nation statistical indices possible. The introduction of KCD-OM3 promotes the diagnostic system by which doctors of Oriental medicine examine classes using the association with KCD-5. It will raise the smoothness and efficiency of oriental medical treatment payments in the health insurance, automobile insurance, industrial accident compensation insurance, etc. In addition, internationally, the eleventh revision work of the ICD has been initiated. It needs to consider incorporating into the International Classification of Diseases some of every country's traditional medicine.

• Journal of Cancer Prevention
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• 제23권4호
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• pp.183-190
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• 2018

Background: As the number of big-cohort studies increases, validation becomes increasingly more important. We aimed to validate administrative database categorized as colorectal cancer (CRC) by the International Classification of Disease (ICD) 10th code. Methods: Big-cohort was collected from Clinical Data Warehouse using ICD 10th codes from May 1, 2003 to November 30, 2016 at Seoul National University Bundang Hospital. The patients in the study group had been diagnosed with cancer and were recorded in the ICD 10th code of CRC by the National Health Insurance Service. Subjects with codes of inflammatory bowel disease or tuberculosis colitis were selected for the control group. For the accuracy of registered CRC codes (C18-21), the chart, imaging results, and pathologic findings were examined by two reviewers. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for CRC were calculated. Results: A total of 6,780 subjects with CRC and 1,899 control subjects were enrolled. Of these patients, 22 subjects did not have evidence of CRC by colonoscopy, computed tomography, magnetic resonance imaging, or positron emission tomography. The sensitivity and specificity of hospitalization data for identifying CRC were 100.00% and 98.86%, respectively. PPV and NPV were 99.68% and 100.00%, respectively. Conclusions: The big-cohort database using the ICD 10th code for CRC appears to be accurate.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제16권2호
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• pp.192-198
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• 2005

본 고찰에서는 DSM-IV의 주의력결핍과잉행동장애(attention-deficit hyperactivity disorder, ADHD)와 ICD-10의 과잉행동장애(hyperkinetic disorder, HKD)의 진단 체계를 비교하였고 그 차이점을 분석하여 임상 및 연구 측면에서 어떠한 의의가 있는지를 살펴보았다. 아직까지 DSM의 ADHD와 ICD의 HKD를 직접 비교한 연구들은 매우 부족한 상태이지만, DSM-IV의 ADHD가 ICD-10의 HKD 보다 광범위한 ADHD의 한 아형라는 것을 알 수 있었다. DSM-IV ADHD의 유병율은 ICD-10 HKD과 비교했을 때 더 높았으며 그 차이는 뚜렷했다. 이러한 결과가 DSM-IV 진단 알고리즘에서 부주의 우세형과 과잉행동-충동성 우세형이 포함되어 ADHD의 범위가 더욱 확장되어 나타난 것인지에 대해서는 아직까지 알 수 없다. 그리고 현재까지 진행된 연구들을 종합해 보았을 때, DSM-IV HKD와 DSM-IV ADHD가 질적으로 같거나 혹은 다르다고 주장할 수는 있는 충분한 근거는 없어 보인다. 다만 HKD가 보다 심한 형태의 ADHD의 한 아형일 가능성이 시사되고 있다. 그러므로 현재로써는 임상에서 환자를 진단하는데 있어 DSM-IV 혹은 ICD-10 중 일방에만 의존하여 ADHD/HKD 장애를 과다하게 진단 내리거나 혹은 실제보다 적게 진단내리는 것을 경계하여야 할 것이다. 특히 질병통계와 보험체계는 WHO의 ICD진단 체계에 맞춰져 있으나 대학이나 전공의 과정 중에는 주로 APA의 DSM진단 기준에 맞춰 학습하는 우리나라의 현실을 감안했을 때 과연 ADHD/HKD에 대한 진단율이 실제 유병율에 비해 과다한지 혹은 부족한지에 대해서도 관심을 기울일 필요가 있다. DSM-IV ADHD와 ICD-10 HKD가 진단적으로 얼마만큼 근접하고 있는지에 대해서는 주요 임상 변인과 endophenotype을 포함한 진단적 타당성에 대한 연구들이 더 진행되고, 관련된 가족연구와 장기 추적 연구들이 뒷받침 되었을 때 보다 명확해질 것으로 생각되며, 또한 ADHD/HKD에 대한 APA와 WHO가 보다 근접하고 일치되는 진단 알고리즘이 개발될 수 있을 것이라 예상된다.

• 한국의료질향상학회지
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• 제10권2호
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• pp.204-215
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• 2003

Background : ICD-10 Classification, which is used domestically as well as internationally, has limited use in the clinical practice since it is developed for at disease statistics and epidemiology. Therefore, the purposes of this study were to improve the quality of diagnosis by constructing a new disease classification based on the diagnoses doctors currently make in the clinical setting and connecting this classification with OCS and EMR, and to meet the demands of doctors for high quality medical study data in medical research. Methods : The specialists in each ophthalmic subfield collected clinical diagnoses and abbreviations based on the ophthalmology textbooks and confirmed the classifications. Total number of clinical diagnoses collected was totaled 672, for which ideal diagnoses had been selected and a new model of disease classification model in connection with ICD-10 was constructed. The constructed classification of clinical diagnoses consisted of six steps: the first step was the classification by ophthalmic subspecialty field; the second to fifth steps were the detailed classification by each specialty field; the sixth step was the classification by site. Results : After introducing the new disease classification, research on the use and a pre-post comparison was conducted. The result from the research on the use of the clinical diagnoses in inpatient and outpatient care has shown a gradually increasing tendency. From the pre-post comparison of EMR discharge summary diagnoses, the result demonstrated that the diagnosis was stated correctly and in detail. Since the diagnosis was stated correctly, code classification became correct as well, which makes it possible to construct high quality medical DB. Conclusion : This construction of clinical diagnoses provides the medical team with high quality medical information. It is also expected to increase the accuracy and efficiency of service in the department of medical record and department of insurance investigation. In the future, if hospitals wish to construct a classification of clinical diagnosis and a standard proposal of clinical diagnosis is presented by a medical society, the standardization of diagnosis seems to be possible.

• Clinical Endoscopy
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• 제56권3호
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• pp.325-332
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• 2023

Background/Aims: Administrative databases provide valuable information for large-cohort studies. This study aimed to evaluate the diagnostic accuracy of an administrative database for resected gastric adenomas. Methods: Data of patients who underwent endoscopic resection for benign gastric lesions were collected from three hospitals. Gastric adenoma cases were identified in the hospital database using International Classification of Diseases (ICD) 10-codes. The non-adenoma group included patients without gastric adenoma codes. The diagnostic accuracy for gastric adenoma was analyzed based on the pathological reports of the resected specimen. Results: Among 5,095 endoscopic resections with codes for benign gastric lesions, 3,909 patients were included in the analysis. Among them, 2,831 and 1,078 patients were allocated to the adenoma and non-adenoma groups, respectively. Regarding the overall diagnosis of gastric adenoma with ICD-10 codes, the sensitivity, specificity, positive predictive value, and negative predictive value were 98.7%, 88.5%, 95.2%, and 96.8%, respectively. There were no significant differences in these parameters between the tertiary and secondary centers. Conclusions: Administrative codes of gastric adenoma, according to ICD-10 codes, showed good accuracy and can serve as a useful tool to study prognosis of these patients in real-world data studies in the future.

• 보건의료산업학회지
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• 제8권3호
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• pp.13-25
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• 2014

This research was performed to investigate the characteristics and determination factors on tertiary hospital inpatients. The used data was the four waves of Korea Health Panel(2008, 2009, 2010, 2011), and the number of subjects was 4,430 cases of tertiary and general hospital admission. The statistical methodology used in the study is the logistic regression model. The significant affecting factors in utilizing tertiary hospital admission were gender, marital status, education, household income, residence region and ICD-10 classification. Man, graduating college/university, married, high-income were socio-economic affecting factors in tertiary hospital admission. Medical need factor of ICD-10 classification and residence region of inpatients was also significant affecting factors in tertiary hospital admission. The 81.4% of inpatients at tertiary hospital had chronic disease and the 12.9% of inpatients readmitted, the 68.2% had a selecting doctor and the only 26.7% of inpatients reinforced by private medical insurance. This study recommended the Korean government to provide proper rule for tertiary hospital admission in order to improve the equity and efficiency of health care system.

• 대한한의학회지
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• 제40권4호
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• pp.29-40
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• 2019

Objectives: To analyze the prescription frequency of various herbs as either individual or major herbs (in terms of dosage) and their usage patterns in the treatment of different diseases for standardization of traditional Korean medicine. Methods: We analyzed the prescription database of patients at the Pusan National University Korean Medicine Hospital from the date of establishment of the hospital to February 2013. The complete prescription data were extracted from the electronic medical records of patients, and the prescription frequencies of individual herbs, particularly, of major herbs, were analyzed in terms of gender, age, and international classification of diseases (ICD) code. Results: The prescription frequency of individual herbs based on age and gender showed a similar pattern. Herbal mixtures were also distributed in a similar manner. The use of some herbs differed according to age and gender (Table 1.). The herbs that were used at high frequencies for a given ICD code had similar usage patterns in different categories. However, some major herbs in the "Jun (King)" category were used uniquely for a given ICD code (Table 2.). There was significant difference between male and female on ICD code E and N, but the other ICD codes had small differences. The ratio of herbal medicine by gender showed different usage patterns in each gender. Conclusions: The findings of our study provide fundamental data that reflect the real clinical conditions in South Korea, and therefore, can contribute to the standardization of TKM.