입원 시 상병(POA) 정보 정확도 평가 향상 방안 개발
- Type
- Research report
- Issued Date
- 2022-12
- Publisher
- 건강보험심사평가원
- Table Of Contents
- 요약 ···························································································· ⅰ
제1장 서론 1
1. 연구의 필요성 ····················································································· 1
가. 의료의 질 및 환자안전 향상을 위한 모니터링 기반 마련 필요 ·············· 1
나. 입원 시 상병 코드 수집의 중요성 ·························································· 2
다. POA 코드의 활용도 증진을 위한 단계적 전략 마련의 필요성 ·········· 4
2. 연구 목적 ································································································· 6
제2장 POA 코드 정확도 및 활용 관련 문헌 검토 9
1. 체계적 문헌고찰 방법론 적용 ····························································· 9
가. 핵심질문(PICO) ······················································································ 9
나. 체계적 문헌고찰 팀 구성 ······································································ 10
다. 문헌 검색 ······························································································ 10
라. 핵심문헌 분류 ······················································································· 11
2. 분석 결과 ·························································································· 16
가. 연구의 특성 ·························································································· 16
나. 주요 결과 ······························································································ 21
3. 소결 ··································································································· 32
제3장 POA 현황 검토 36
1. 연구 방법 ·························································································· 36
2. POA 코드 현황 분석 결과 ································································ 38
가. POA 코드 입력 현황 ············································································ 38
나. 진료비 지불제도에 따른 POA 코드 입력 현황 ····································· 46
다. 예외상병 코드에 따른 POA 코드 입력 현황 ········································· 58
3. 소결 ··································································································· 66
제4장 POA 코드 정확도 평가 분류체계 개발 및 적용 70
1. POA Y 코드 정확도 평가 분류 체계 개발 및 적용 ·························· 70
가. 연구 방법 ······························································································ 70
나. POA Y 타당도 분류 체계 활용한 POA Y 코딩 정확도 평가 ··············· 78
2. 환자안전사건 코드를 활용한 POA N 코드 정확도 평가 ··················· 91
가. 연구 방법 ······························································································ 91
나. 한국형 환자안전사건 코드를 활용한 POA N 코딩 정확도 평가 ··········· 94
3. 소결 ································································································· 116
제5장 POA 코드 활용도 증진을 위한 검토 120
1. 중증도 보정 사망모형 ····································································· 120
가. 의료기관 중증도 보정 사망지표 ·························································· 120
나. 산출방법 ······························································································ 122
다. 산출결과 ······························································································ 128
2. 타 자료원과의 연계를 통한 POA 코드 활용도 증진 ······················· 139
가. 연구 방법 ···························································································· 139
나. 분석결과 ······························································································ 140
3. 소결 ································································································· 151
제6장 POA 코드 관련 실무 담당자 대상 초점집단토의 155
1. 연구 방법 및 분석 ··········································································· 155
가. 연구팀 구성 ························································································ 155
나. 연구참여자 ·························································································· 155
다. 자료 수집 방법과 절차 ······································································· 156
라. 분석방법 및 절차 ················································································ 156
2. 결과 ································································································· 158
가. 연구참여자 인구사회학적 특성 ··························································· 158
나. 분석 결과 ···························································································· 159
3. 소결 ································································································· 169
제7장 POA 코드 활용을 위한 지표 개발 173
1. 지표 개발 필요성 ············································································ 173
2. 지표 개발 방법 ················································································ 174
3. 환자안전 및 의료 질 관련 지표 ······················································ 176
가.「환자안전법」····················································································· 176
나.「의료법」 내 감염관리 ······································································· 187
다.「의료사고 피해구제 및 의료분쟁 조정 등에 관한 법률」·················· 193
라. 국외 사례: 미국의 의무기록 향상 프로그램 (CDI, Clinical documentation improvement/integrity) ············································································· 194
4. POA 코드 활용을 위한 지표 제안 ·················································· 197
가. 구조 지표 ···························································································· 197
나. 과정 지표 ···························································································· 203
다. 결과 지표 ···························································································· 208
제8장 결론 및 제언 213
1. 제언 ································································································· 213
2. 결론 ································································································· 217
◾ 참고 문헌 ··················································································· 218
◾ 부록 ···························································································· 222
◾ ABSTRACT ··············································································· 259
- Publisher
- 건강보험심사평가원
- Location
- KOR
- Citation
- 옥민수. (2022-12). 입원 시 상병(POA) 정보 정확도 평가 향상 방안 개발.
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