우리나라 의료기관의 질병 코딩 불일치성 분석 : 외래환자 건강보험 청구 자료를 중심으로
An Analysis of the Disagreement in Disease Coding in South Korean Medical Institutions : Focusing on the Health Insurance Claim Data of Outpatients
- Resource Type
- Article
Text
- Authors
- 전윤희; 강길원; Yun-Hee Jeon; Gil-Won Kang
- Source
- 디지털융복합연구, 12/31/2018, Vol. 16, Issue 12, p. 533-540
- Subject
- 동일 질환
질병 코딩
의료기관
일치
불일치
Same disease
Disease coding
Medical institutions
Agreement
Disagreement
- Language
- 한국어(KOR)
- ISSN
- 2713-6434
The purpose of this study was to use the data from the Health Insurance Review and Assessment Service to analyze the disagreement in disease coding given by different medical institutions on the same disease of the same patient and provide basic data that could help improve the quality of national public health statistics. 9,976,826 patients’ data records from the Health Insurance Review and Assessment Service-National Patient Sample (HIRA-NPS) of 2014 were analyzed. The disagreement in disease coding differed by movement paths for medical institutions; the disagreement rate tended to increase when moving from a medical institution other than public health centers to a public health center and decrease remarkably when moving from a specialized general hospital to another. Therefore, this analysis of disagreement in disease coding among medical institutions suggests the need to supplement the system so that domestic medical institutions can realize consistent disease coding.