How Does the Accuracy of ICD Coding Influence for Resource Consumption Under the Casemix Based Evaluation

抄録

In this article, the authors tried to clarify the importance of accurate coding for appropriate evaluation under the casemix scheme. For this study, we have extracted 28,995 stroke cases with sufficient information of ICD coding from the DPC database (1st July 2008 to 31st October 2008). Based on this data set, we have classified the cases into following 3 types: atherothrombotic, thrombus and lacna type using the ICD coding information. Then we analyzed the differences in these 3 types for demographic factors (age), clinical outcome (ADL status at admission and discharge), and cost (charged cost based on F file). Results showed that clinical characteristics and resource consumptions have been different among the stroke type even though the 3 types (atherothrombotic, lacunar and embolic) are classified into the same base DPC (010060). Embolic type of stroke cases showed longer length of stay, heavier level of ADL decline and larger cost consumption with statistical significance (p<0.01). The present results have indicated the importance of accuracy of ICD coding under the casemix based evaluation system.