보건행정학회지 (Health Policy and Management)

  • 제26권4호
  • /
  • Pages.289-304
  • /
  • 2016
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  • 1225-4266(pISSN)
  • /
  • 2289-0149(eISSN)
한국보건행정학회 (Korean Academy of Health Policy and Management)
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한국형 재활환자분류체계 버전 1.0 개발

The Development of Korean Rehabilitation Patient Group Version 1.0

  • Hwang, Soojin (Health Insurance Review and Assessment Service) ;
  • Kim, Aeryun (Health Insurance Review and Assessment Service) ;
  • Moon, Sunhye (Health Insurance Review and Assessment Service) ;
  • Kim, Jihee (Health Insurance Review and Assessment Service) ;
  • Kim, Jinhwi (Health Insurance Review and Assessment Service) ;
  • Ha, Younghea (Health Insurance Review and Assessment Service) ;
  • Yang, Okyoung (Health Insurance Review and Assessment Service)
  • 투고 : 2016.06.07
  • 심사 : 2016.12.29
  • 발행 : 2016.12.31
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초록

Background: Rehabilitations in subacute phase are different from acute treatments regarding the characteristics and required resource consumption of the treatments. Lack of accuracy and validity of the Korean Diagnosis Related Group and Korean Out-Patient Group for the acute patients as the case-mix and payment tool for rehabilitation inpatients have been problematic issues. The objective of the study was to develop the Korean Rehabilitation Patient Group (KRPG) reflecting the characteristics of rehabilitation inpatients. Methods: As a retrospective medical record survey regarding rehabilitation inpatients, 4,207 episodes were collected through 42 hospitals. Considering the opinions of clinical experts and the decision-tree analysis, the variables for the KRPG system demonstrating the characteristics of rehabilitation inpatients were derived, and the splitting standards of the relevant variables were also set. Using the derived variables, we have drawn the rehabilitation inpatient classification model reflecting the clinical situation of Korea. The performance evaluation was conducted on the KRPG system. Results: The KRPG was targeted at the inpatients with brain or spinal cord injury. The etiologic disease, functional status (cognitive function, activity of daily living, muscle strength, spasticity, level and grade of spinal cord injury), and the patient's age were the variables in the rehabilitation patients. The algorithm of KRPG system after applying the derived variables and total 204 rehabilitation patient groups were developed. The KRPG explained 11.8% of variance in charge for rehabilitation inpatients. It also explained 13.8% of variance in length of stay for them. Conclusion: The KRPG version 1.0 reflecting the clinical characteristics of rehabilitation inpatients was classified as 204 groups.

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