HIRA

병원 표준화 사망비 평가 개선 방안

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Type
Research report
Author(s)
신민선심보람이유진
Issued Date
2020-01
Publisher
건강보험심사평가원
URI
https://repository.hira.or.kr/handle/2019.oak/2997
Table Of Contents
요 약 ···········································································································12

제1장 서 론 ··································································································1
1. 연구 배경 및 필요성 ·····································································································1
2. 연구목적 ························································································································3
3. 연구내용 및 방법 ··········································································································4
가. 연구내용 ·················································································································4
나. 연구방법 ·················································································································4

제2장 병원 표준화 사망비 개념 및 평가현황 ·············································7
1. 병원 표준화 사망비 개념 ·····························································································7
가. 병원 표준화 사망비 정의 및 산출모형 ·································································7
나. 의료 질 지표로서 병원 표준화 사망비 ·······························································9
2. 국내 병원 표준화 사망비 평가 현황 ··········································································11
가. 평가 경과 ·············································································································11
나. 병원 표준화 사망비 평가 현황 ···········································································13

제3장 병원 표준화 사망비 방법론 검토 ····················································19
1. 검토 대상 및 범위 ······································································································19
2. 방법론 검토 ·················································································································22
가. 중증도 보정변수 ···································································································22
나. 위험요인 선정 방법 ·····························································································26
다. 타당도 평가방법 ···································································································28
라. 최소건수 기준 ······································································································30
마. 추세 분석 적용 ····································································································33
바. 동질그룹별 결과 ···································································································35
사. 결과 표현 방법 ····································································································38
아. 의료기관별 공개 ···································································································43
자. 기타 ······················································································································48
3. 개선모형 적용 방향 ····································································································50

제4장 병원 표준화 사망비 모형 개발 ························································55
1. 모형 개발 방법 ···········································································································55
가. 자료 범위 ·············································································································55
나. 단계별 모형 개발 방법 ························································································56
2. 병원 표준화 사망비 모형개발 대상 선정 ···································································58
가. 병원 내 사망 현황 ·······························································································58
나. 모형개발 대상 선정 ·····························································································62
3. 후보변수 선정 ·············································································································64
가. 후보 변수 목록 ··································································································64
나. 후보 변수 선정 ····································································································67
4. 중증도 보정 모형 개발 ·······························································································76
가. 중증도 보정 모형 선정 ························································································76
나. 모형 타당도 평가 ·································································································77
5. 소결 ·····························································································································81

제5장 병원 표준화 사망비 모형 적용 ························································83
1. 병원 표준화 사망비 모형 적용 결과 ··········································································83
가. 최종 중증도 보정 모형 ························································································83
나. 표준화 사망비 ······································································································88
다. 병원 표준화 사망비 ·····························································································96
2. 추세 분석 결과 ·········································································································106
가. 표준화 사망비 ····································································································106
나. 병원 표준화 사망비 ···························································································108

제 6장 결론 및 고찰 ···············································································115
1. 결론 ···························································································································115
2. 고찰 ···························································································································116
가. 연구의 제한점 ····································································································116
나. 제언 ····················································································································119

참고문헌 ···································································································125

부록 ··········································································································129
Publisher
건강보험심사평가원
Location
KOR
Citation
신민선 et al. (202001). 병원 표준화 사망비 평가 개선 방안.
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