Use of classifications in Korea The 6th Meeting of the Asia Pacific Network of the WHO Family of International Classifications Bangkok July 18, 2013 Korean.

Use of classifications in Korea

The 6th Meeting of the Asia Pacifi c Network of the WHO Family of International Classifi cationsBangkok

July 18, 2013

Korean Collaborating Center Sukil Kim

Current status of ICD in Korea• Maintenance• Usage

Changing health information envi-ronment• Change of hospital information system• New roles of health information man-

ager• Action to be taken for the future

Contents

Status of ICD

By the Statistics Korea under the law• Practically by Korean Medical Record

Association (KMRA) Local extension by large scale hospi-

tals KCD-6 since 2011

• Modification of ICD-10 2008version

Maintenance

Vital statistics Administration, clinical care and re-

search• Health insurance claims (Fee For Ser-

vice)• Hospital administration• Electronic Medical (Health) Record• OECD reports

Use of mortality and morbidity data

National death registration system• Operation

• Ministry of Security and Public Adminis-tration

• Submission of death certificates signed by doctors to regional district office

• No funeral without the document

• Ministry of Health and Welfare

• Annual report• By Statistics Korea since 1980

Mortality statistics

Status of mortality data in Korea by Colin D. Mathers, et al. Mar. 2005, WHO Bulletin• Coverage: 88%• ill-defined code: 14%

Mortality statistics

1980 1990 2000 2010

Health insurance program for public officers and private school employees

Health insurance program for private companies

Health insurance for all Korean

Health insurance reformSeparation of prescribing and dispensing of drug

Softwarefor medical claims

EMR market for private clinics

EDI for insurance clams

CPOE

e-prescription

Concept of EHR

Hospital EMR

Partial approval of electronic prescription, Electronic health record, Telehealth by revision of the law

Trend of health information system in Ko-rea

Diagnosis No. of pt. LOS %

1 Liver & Bile duct cancer 6760 11.3 8.4

2 Chronic ischemic heart disease 3689 5.7 4.6

3 Stomach cancer 3337 9.3 4.1

4 Lung cancer 2035 4.5 2.5

5 Chronic renal failure 1885 9.3 2.3

6 Cholelithiasis 1820 9.7 2.3

7 Cataract 1590 2.1 2.0

8 Liver cirrhosis 1481 12.6 1.8

9 Leukemia 1096 21.0 1.4

10 Breast cancer 1063 12.3 1.3

……………. … … …

100 Necrosis of bone 148 17.2 0.2

Total 59128 (83371)

9.3 (8.7)

73.3(100)

Hospital morbidity statistics by the main con-dition of patients in an university hospital

Use of ICD for Hospital manage-ment

•

• 1.61

• 1.27

• 0.90

• 1.31• 1.17

• 1.42• 1.42

• 2.03

• 0.94 • 0.79• 0.71

• 0.28• 0.25

• 0.92

• 0.46• 0.59

• 0.0

• 0.5

• 1.0

• 1.5

• 2.0

• 2.5

• 월 • 화• 수• 목 • 금• 토 • 일• 공휴일

• 2002 • 2001• 2002 전체 • 2001 전체

Average LOS of patients with cataract •

• 0.83• 0.75

• 0.63

• 0.93

• 1.35• 1.38

• 0.83• 1.08

• 0.88

• 1.29• 1.32

• 1.02

• 1.10

• 0.54

• 1.13

• 0.83

• 0.0

• 0.5

• 1.0

• 1.5

• 2.0

• 2.5

• 월• 화• 수• 목• 금• 토• 일• 공휴일

• 2002 • 2001• 2002 전체 • 2001 전체

Average LOS of patients with ton-sillectomy

90% of private sector One and only one national health in-

surer Legal submission of medical claims

to reviewer (Health Insurance re-view and assessment service)

Fee For Service system for both out-patient and inpatient services

Healthcare system

HIS (Hospital Information System) - EMR, OCS(CPOE), CRM, FACS, ERP

EDIDisk (CD, DAT)

Multiple Bar

Coded Paper

Web

Reimbursement of health insur-ance and claims review

HIRA

Reimbursement purposes• Code shift – main condition• Too many additional codes

Health Information Manager• Involved in the valid data for research

and internal management of hospitals

Obstacles

Coding education included in HIM program• University• College

National license since 1985 Continuing education

• By Korean Medical Record Association

Clinical coders in Korea

Thank you