Journal of the Korea Convergence Society (한국융합학회논문지)

Korea Convergence Society (한국융합학회)
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A study on the change of complication incidence rate according to introduction of quality evaluation by the DRG payment -focussing on patients with lens surgery

질병군 포괄수가 적정성 평가 도입에 따른 합병증 발생률 변화에 대한 연구 -수정체 수술 환자를 대상으로

  • Kim, Myoung-Ok (Dept. of Hospital Management, Graduate School of Public Health and Welfare) ;
  • Park, Arma (Konyang University.Dept. of liveral Education) ;
  • Lee, Chong Hyung (Konyang University.Dept. of Hospital Management, Konyang University) ;
  • Kim, Kwang-Hwan (Konyang University.Dept. of Hospital Management, Konyang University)
  • 김명옥 (건양대학교 보건복지대학원 병원경영학과) ;
  • 박아르마 (건양대학교 기초교양교육대학) ;
  • 이종형 (건양대학교 병원경영학과) ;
  • 김광환 (건양대학교 병원경영학과)
  • Received : 2018.03.29
  • Accepted : 2018.06.20
  • Published : 2018.06.28
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Abstract

The purpose of this study is to investigate incidence rates of complications in response to the introduction of quality evaluation of the DRG(diagnosis related group) payments, focusing on an increasing number of patients with lens surgery as the population aging increases.Fourthly, there were three dependent variables ('vitreous prolapse', 'IOP elevations', and 'other complications') in this study, and therefore multivariate logistic regression was performed. The result of the analysis indicates that as the number of hospitalized days increased, vitreous prolapse decreased to 0.27 times(95% CI 0.08~1.00) and IOP elevation decreased by 0.14 times(95% CI 0.03~1.59), compared to other complications, and this was statistically significant. From the above results, this study is meaningful in that it has compared the evaluation results of the appropriateness of DRG payment and the medical quality for lens surgery complications patients, in response to the introduction of quality evaluation by DRG payment.

본 연구는 인구 고령화에 따라 증가하고 있는 안과 질병군(DRG)포괄수가 수정체 수술 환자를 중심으로 질병군(DRG)포괄수가 적정성 평가도입에 따른 수술합병증 발생률 변화를 파악하고자 시행하였다. 연구대상은 2016년 1월부터 12월까지 1년간, 전국소재, 전 종별(상급종합병원, 종합병원, 병원, 의원)에서 청구하는 질병군(DRG)포괄수가 수정체 수술 환자의 건강보험 및 보훈 진료비용이다. 본 연구에서 종속변수는 '유리체탈출', '안압상승', '기타합병증'으로 세 가지 항목을 포함하고 있어 다항로지스틱 회귀분석을 실시하였으며 분석결과 기타합병증군에 비해 유리체탈출군이 재원일수가 늘어날수록 0.27배(95% CI 0.08~1.00), 안압상승군은 0.14배(95% CI 0.03~1.59) 줄어들었고 이는 통계적으로 유의하였다. 이상과 같은 결과 질병군(DRG)포괄수가 적정성 평가 도입에 따른 수정체 수술 합병증 환자를 대상으로 질병군 적정성 평가 결과와 질병군 수술 합병증의 의료의 질을 비교를 하였다는 점에서 의의가 있다.

Keywords

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