A review of the complexity adjustment in the Korean Diagnosis-Related Group (KDRG)

Health Information Management : Journal of the Health Information Management Association of Australia
Sujeong KimSukil Kim

Abstract

The Korean Diagnosis-Related Groups (KDRG) was revised in 2003, modifying the complexity adjustment mechanism of the Australian Refined Diagnosis-Related Groups (AR-DRGs). In 2014, the Complication and Comorbidity Level (CCL) of the existing AR-DRG system was found to have very little correlation with cost. Based on the Australian experience, the CCL for KDRG version 3.4 was reviewed. Inpatient claim data for 2011 were used in this study. About 5,731,551 episodes, which had one or no complication and comorbidity (CC) and met the inclusion criteria, were selected. The differences of average hospital charges by the CCL were analysed in each Adjacent Diagnosis-Related Group (ADRG) using analysis of variance followed by Duncan's test. The patterns of differences were presented with R2 in three patterns: The CCL reflected the complexity well (VALID); the average charge of CCL 2, 3, 4 was greater than CCL 0 (PARTIALLY VALID); the CCL did not reflect the complexity (NOT VALID). A total of 114 (19.03%), 190 (31.72%) and 295 (49.25%) ADRGs were included in VALID, PARTIALLY VALID and NOT VALID, respectively. The average R2 for hospital charge of CCL was 4.94%. The average R2 in VALID, PARTIALLY VALID and NOT VALID was 4.54%, 5.21%, and 4...Continue Reading

References

Jan 1, 1982·Annals of Internal Medicine·S A Finkler
Jan 31, 2003·European Journal of Clinical Nutrition·G W Tannock
May 28, 2014·The Journal of Hand Surgery·Maria I Opanova, Robert E Atkinson
Jul 21, 2015·International Journal of Health Policy and Management·Gerli Paat-Ahi
Nov 2, 2015·Health Policy·Terri JacksonSteve Gillett

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May 10, 2020·Health Information Management : Journal of the Health Information Management Association of Australia·Jennie Shepheard, Andrea Groom
Sep 13, 2019·Health Information Management : Journal of the Health Information Management Association of Australia·Jennie Shepheard

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