• 웰빙융합연구
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• 제6권3호
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• pp.1-11
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• 2023

Purpose: This research aims to facilitate a smooth transition from KCD-8 to ICD-11 through the study of ICD-11. Research design, data and methodology: Skilled Health Information Managers (HIMs) in Korea performed manual mapping and conducted a study of the code structure of ICD-11 chapters 11 and 12. Results: When comparing the granularity between ICD-11 and KCD-8, 58.1% of ICD-11 codes showed higher granularity, and 38.6% had similar granularity. The granularity of the circulatory system was higher than that of the respiratory system. When comparing the KCD-8 codes mapped by ICD-11 with the total 924 KCD-8 codes, it was found that about 50% of KCD-8 codes were not mapped to ICD-11. This means that 50% of diseases in the KCD-8 do not have individual codes as they did in ICD-11. Conclusions: ICD-11 demonstrated high granularity, indicating its effectiveness in describing cutting-edge medical technology in modern society. However, we also observed that some diseases were removed from KCD-8, while others were added to ICD-11. To ensure smooth statistics transition from KCD8 to ICD-11, especially for leading domestic diseases, integrated management, including the preparation of KCD-9 reflecting ICD-11 and ICD-11 training, will be necessary through the analysis of new codes and the removal of codes.

• 대한한의학회지
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• 제44권1호
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• pp.1-15
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• 2023

Objectives: National health insurance herbal prescription of Korean medicine has been serving important role in public healthcare in spite of continuous demand on revision of system. However, the categories of insurance herbal prescriptions are not equally distributed throughout the KCD-based major disease categories. We analyzed statistical database of claimed national health insurance classified as major disease categories by years. We classified all 56 herbal prescriptions as per their total medical indications into 22 major disease categories to analyze their distribution. Significant increase of M and S-T code claims were found, whereas decrease of U code claims by years. We figured out that the 56 prescriptions were unequally distributed along with enrichment of certain codes such as K and J. Meanwhile, the insurance claim of each prescription was positively correlated with number of code types of their indications. As a result, we believe that the reform of national health insurance herbal prescription list is necessary to promote use of it in clinic.

• 대한한방부인과학회지
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• 제32권1호
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• pp.73-84
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• 2019

Objectives: The purpose of this study is to collect and analyze the KCD codes applied to the treatment of 27 postpartum women who had been treated with Korean traditional medicine in a Korean medicine hospital, so that this study may be used as a basic data for setting the direction of postpartum Korean medical treatment research. Methods: It was approved by the Institutional Review Board (IRB) of ${\bigcirc}{\bigcirc}$ University medical center (IRB approval number : WSOH IRB H1708-02-01). Twenty-seven postpartum women who had been treated at ${\bigcirc}{\bigcirc}$ University medical center were received outpatient treatment for two weeks (from September 27, 2017 to January 5, 2018), and the KCD codes applied to the mothers were collected after obtaining the consent. On the day of registration of the study, the fertility, obstetric history and high-risk pregnancies were identified through an interview. Results: 1. The mean age of the 27 subjects was $33.33{\pm}3.99\;years$ old. Among the subjects, 17 mothers (63.0%) were high-risk pregnancy and 10 mothers (37.0%) were normal. 2. Among the 22 major disease categories, 8 categories were used. M code (musculoskeletal system) was used 243 times (70.85%), followed by R code (unclassified symptom) of 51 times (14.87%) and U code (special purpose code) of 23 times (6.71%). 3. The most commonly used code among the ten frequently used codes was M25.57 (joint pain, ankle and foot), a total of 47 times. Of the remaining nine codes, except for R60.1 (systemic edema) and U68.4 (The deficiency of yang in Bi), all codes were M codes (musculoskeletal system). 4. The M code (musculoskeletal system) was the most used major disease category in high-risk group, a total of 159 times. But in specific categories, the most commonly used code was R60.1 (systemic edema), a total of 28 times. 5. In normal group, the M code (musculoskeletal system) was the most used major disease category, a total of 84 times. Also, in specific categories, the most commonly used code was M25.57 (joint pain, ankle and foot), total 29 times. 6. The U code, corresponding to 'the diagnosis of childbirth and other obstetrical medical use', was used 23 times (6.71%), O code three times (0.87%) and Z code two times (0.58%), which was less than 10% of the total number of codes used. Conclusion: When analyzing KCD codes related to Korean medicine treatment for postpartum diseases, it is important to select the KCD codes that reflect the actual clinical state.

• 동의생리병리학회지
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• 제30권2호
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• pp.124-130
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• 2016

The aim of this study was to suggest the future direction of diagnostic and evaluative pattern identification questionnaire (PIQ) by reviewing the state of development and utilization of PIQ according to Korean classification of disease-U (KCD-U). We surveyed the database of OASIS, NDSL, KISS, DBPIA, and Pub-med to know the kinds of developed and developing PIQ of Korean medicine. We used 'Pattern Identification' and 'Questionnaire' to find suitable papers. The inclusion criteria met 47 cases. The number of PIQ before 2000yrs, between 2001 to 2005, 2006-2010, 2011-2015 were 2, 5, 18, 22cases. The number of PIQ belonged to the disease of Korean medicine, the pathological symptom of korean medicine, the Sasang constitutional pattern identification and etc according to KCD-U were 20(42.6%), 8(17%), 9(19.1%) and 10(21.3%). Twenties among forty seven PIQ were validated, and the rest of them were not validated. The distribution of the numbers of PIQ were significantly different according to KCD-U (p=0.003). The direction of Utilization of PIQ was 36 questionnaires in diagnosing PI, 14 cases in evaluating health state, 4cases in evaluating effects of a treatment and 8 ones in diagnosing Sasang constitutional types. This study reveals the status on validated and non-validated PIQ of Korean medicine and suggests the basic information for the direction of developing PIQ in the future.

• 대한예방한의학회지
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• 제22권2호
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• pp.55-63
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• 2018

Objectives : This study was conducted to survey on the research trends of Pharmacopuncture in Korea. Methods : We searched Korean research database by using keyword 'Pharmacopuncture', 'Bee venom'. Korean research databases were Korean Studies Information Service System(KISS), Research Information Service System(RISS), National Digital Science Library(NDSL) and Korean Medicine Information System(OASIS). We classified articles identified by publish year, type of research and diseases. Results : We analyzed 533 studies. Clinical studies and non-clinical studies except literature studies were decreased from 2015. However, Literature studies had not shown particular change over the past decade. Pharmacopuncture treated disease was classified by Korean standard classification of disease(KCD), M-code (37.8%), G-code(18.4%) were frequently used. Conclusions : A variety of disease was treated by pharmacopuncture. It is necessary to increase the level of evidence of pharmacopuncture. through additional studies in the future.

• Journal of Oral Medicine and Pain
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• 제47권3호
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• pp.109-116
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• 2022

Purpose: This study was conducted to analyze the clinical characteristics and distribution of the tongue-related diagnoses in patients with tongue symptoms. Methods: The subjects were patients who visited Chosun University Dental Hospital with tongue symptoms from January 1, 2021, to December 31, 2021. We analyzed 491 patients (139 males and 352 females) with tongue-related diagnostic code names in the Korean Standard Classification of Disease (KCD) in the Electronic Medical Record (Dentopinformation Technology Co., Seoul, Korea). Results: On analyzing the diagnoses of tongue diseases using the KCD, glossopyrosis (44.8%) and painful tongue (15.2%) showed high rates. Of the 491 patients, 139 (28.3%) were males and 352 (71.7%) were females, and the average age was 58.1 years. As for systemic diseases, there were many patients with diseases of the circulatory system (27.0%) and endocrine, nutritional, and metabolic diseases (13.7%). Tongue symptoms were discomfort in 58 patients, pain in 329 patients, paresthesia in 10 patients, burning sensations in 222 patients, dysgeusia in 25 patients, dryness in 110 patients, fissures in 57 patients, and other symptoms in 72 patients. Areas with tongue symptoms were the anterior area in 102 patients, the lateral area in 140 patients, the posterior area in 12 patients, the dorsal area in 140 patients, the ventral area in 42 patients, and which area in 126 patients overall. Patients with burning mouth syndrome and oral candidiasis had significantly more tongue symptoms. Conclusions: Patients with tongue symptoms exhibited a variety of tongue diseases. Tongue symptoms were more common in women over 50 years of age and were frequently seen in patients with burning mouth syndrome and oral candidiasis.

• 한국임상약학회지
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• 제27권3호
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• pp.127-135
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• 2017

Background: Kawasaki disease (KD) is an acute febrile, systemic vasculitis as a leading cause of acquired heart disease in children. Intravenous immunoglobulin G (IVIG) and aspirin are the standard initial therapy in the treatment of acute KD. The purpose of this study was to investigate drug utilization in children with KD, and to compare "IVIG + high-dose aspirin" and "IVIG + moderate-dose aspirin" in preventing cardiac complications. Methods: We analyzed pediatric patient sample data compiled by the Health Insurance Review & Assessment Service from 2010 to 2015. We identified patients with KD using the KCD-6 code of M30.3. We excluded patients in chronic phase or ${\geq}1$0 years. We also excluded patients who were diagnosed KD in November or December. Drug utilization pattern were assessed in acute KD patients and 30-day and 60-day cardiac complications were investigated between "IVIG + high-dose aspirin" group and "IVIG + moderate-dose aspirin" group. Results: In acute phase, IVIG was administered to 95.8% patients, and 57.1% patients were prescribed moderate-dose aspirin and 25% patients were with high-dose aspirin. Steroid use was rapidly increased from 4.0% in 2010 to 11.3% in 2015. Both 30-day and 60-day cardiac complications occurred less in "IVIG + high-dose aspirin" group compared to "IVIG + moderate-dose aspirin" group, but not statistically significant (0.9% vs 1.8%, p=0.252 for 30-day complication rate; 1.5% vs 2.7%. p=0.073 for 60-day complication rate). Conclusion: We were not able to demonstrate which aspirin therapy is superior for preventing cardiac complications in acute KD patients and further research is warranted.

• 한국산학기술학회논문지
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• 제19권11호
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• pp.126-136
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• 2018

본 연구는 머신러닝을 활용하여 급성 뇌졸중 퇴원 환자의 중증도 보정 사망 예측 모형 개발을 목적으로 시행하였다. 전국 단위의 퇴원손상심층조사 2006~2015년 자료 중 한국표준질병사인분류(Korean standard classification of disease-KCD 7)에 따라 뇌졸중 코드 I60-I63에 해당하는 대상자를 추출하여 분석하였다. 동반질환 중증도 보정 도구로는 Charlson comorbidity index(CCI), Elixhauser comorbidity index(ECI), Clinical classification software(CCS)의 3가지 도구를 사용하였고 중증도 보정 모형 예측 개발은 로지스틱회귀분석, 의사결정나무, 신경망, 서포트 벡터 머신 기법을 활용하여 비교해 보았다. 뇌졸중 환자의 동반질환으로는 ECI에서는 합병증을 동반하지 않은 고혈압(hypertension, uncomplicated)이 43.8%로, CCS에서는 본태성고혈압(essential hypertension)이 43.9%로 다른 질환에 비해 가장 월등하게 높은 것으로 나타났다. 동반질환 중중도 보정 도구를 비교해 본 결과 CCI, ECI, CCS 중 CCS가 가장 높은 AUC값으로 분석되어 가장 우수한 중증도 보정 도구인 것으로 확인되었다. 또한 CCS, 주진단, 성, 연령, 입원경로, 수술유무 변수를 포함한 중증도 보정 모형 개발 AUC값은 로지스틱 회귀분석의 경우 0.808, 의사결정나무 0.785, 신경망 0.809, 서포트 벡터 머신 0.830로 분석되어 가장 우수한 예측력을 보인 것은 서포트 벡터머신 기법인 것으로 최종 확인되었고 이러한 결과는 추후 보건의료정책 수립에 활용될 수 있을 것이다.

• 한국임상약학회지
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• 제32권3호
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• pp.155-165
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• 2022

Background: Chronic obstructive pulmonary disease (COPD) is not completely reversible and requires long-term management with appropriate treatment. This study aimed to analyze trends in treatment regimens and medication costs for COPD patients using a national claims database. Methods: We conducted this analysis using National Patient Sample data from the Health Insurance Review and Assessment Service covering the period from 2015 to 2018. We have constructed a dataset comprising COPD disease classification codes J43.x and J44.x (based on KCD-7 code, J43.0 was excluded) and compiled a list of drugs fitting current guidelines. To identify trends, we calculated frequency, ratio, and compound annual growth rate (CAGR) using the numbers of prescriptions and patients. Results: The number of COPD patients was 7,260 in 2018, slightly decreased from 2015. Most of these COPD patients were aged 60 or older and included a high proportion of males (72.2%; 2018). The number of patients prescribed inhaled medications increased gradually from 2015 to 2018 (9,227 (47.1%); 2015, 9,285 (51.5%); 2018), while the number of patients prescribed systemic beta-agonists and Xanthines has decreased since 2015 (CAGR -14.7; systemic beta-agonist, -5.8; Xanthines). The per capita cost of medication has increased by 0.4% (KRW 206,667; 2018, KRW 204,278; 2015) annually during the study period. Conclusion: This study showed that treatment with inhaled medications had continuously increased in accord with changing guidelines, but oral medications were still widely used. It is necessary to emphasize the importance of inhaled medications in treating COPD to reduce additional economic burden through appropriate medication use.

• 한국콘텐츠학회논문지
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• 제16권10호
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• pp.196-205
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• 2016

본 연구의 목적은 2006년부터 2012년까지의 질병관리본부의 퇴원손상심층조사 자료를 바탕으로 결핵환자의 환자 특성과 입원 및 질병관련 특성, 의료기관 특성에 따른 의료이용 현황과 치료결과에 영향을 미치는 요인을 파악하고자 한다. 본 연구는 질병관리본부에서 제공하는 퇴원손상심층조사자료를 활용하였고, 제6차 한국표준질병사인분류(KCD-6)의 중분류상 퇴원시 주진단 코드와 부진단 코드가 결핵(A15.0~A19.9)인 환자를 추출하여 총 8,305건을 최종 분석에 사용하였다. 본 연구에서 수집된 자료는 통계 프로그램 SPSS 20(Statistical Package for the Science)을 이용하여 빈도분석, 교차분석(chi-square test)과 로지스틱 회귀분석을 실시하였다. 연구결과는 먼저, 환자 특성과 치료결과가 호전되었는지의 관련성에 있어서는 연령그룹이 20-39세, 40-64세, 65세 이상과 의료급여의 결핵환자가 호전될 확률이 모두 통계적으로 유의하게 높았다(p<0.000). 그 다음, 입원 및 질병관련 특성과 치료결과와의 관련성 분석에서는 A16, A17, A19(p<0.000)와 A18(p<0.002) 모든 결핵코드와 재원일수가 31-90일(p<0.000)과 91-180일(p<0.041)인 경우에 호전될 확률이 통계적으로 유의하게 높았다. 마지막으로, 의료기관 특성과 치료결과의 관련성 분석에서는 300-499(p<0.008), 500-999(p<0.011), 1,000병상 이상(p<0.015)과 도지역(p<0.041)의 경우 호전될 확률이 통계적으로 유의하게 높았다(p<0.015). 결과적으로 결핵환자 발생시 철저한 접촉자 조사 및 예방치료, 정기적인 검진을 통한 조기 발견 방안 등 정부에서도 성공적인 결핵환자관리 프로그램을 지원하고 이를 적절하게 뒷받침 할 수 있는 단기적 뿐만 아니라 중장기적으로 종합적인 정책을 추진해야 한다.