The Accuracy of Myocardial Infarction Diagnosis in Medical Insurance Claims

Yonsei Medical Journal

Volumn 41, Issue 5, 2000, Pages 570-576

  Ryu, So Yeon ^a   Park, Jong Ku ^b   Suh, Il ^c   Jee, Sun Ha ^c   Park, Jong ^a   Kim, Chun Bae ^b   Kim, Ki Soon ^a  

^a Chosun University   (South Korea)

^b Yonsei University Wonju   (South Korea)

^c Yonsei University   (South Korea)

Author keywords

Accuracy rate; Medical insurance claims; Myocardial infarction; Surveillance system

Indexed keywords

ARTICLE; COHORT ANALYSIS; HEALTH INSURANCE; HEALTH SURVEY; HEART INFARCTION; HUMAN;

COHORT STUDIES; HUMANS; INSURANCE, HEALTH; MYOCARDIAL INFARCTION; SENTINEL SURVEILLANCE;

EID: 0348232815     PISSN: 05135796     EISSN: None     Source Type: Journal    
DOI: 10.3349/ymj.2000.41.5.570     Document Type: Article

References (31)

1. National Statistical Office. Annual report on the cause of death statistics (based on vital registration). Seoul, Korea: National Statistical Office; 1998.
2. Suh I, Jee SH, Kim IS. Changing pattern of cardiovascular diseases in Korea. Korean J Epidemiol 1993;15:40-6.
3. National Statistical Office. Annual report on the cause of death statistics (based on vital registration). Seoul, Korea: National Statistical Office; 1996.
4. Park JG. Modern epidemiology. 1st ed. Seoul: Yonsei University Press; 1999.
5. Burke GL, Sprafka JM, Folsom AR, Luepker RV, Norsted SW, Blackburn H. Treads in CHD mortality, morbidity and risk factor levels from 1960 to 1986: The Minnesota Heart Survey. Int J Epidemiol 1989;18 Suppl 1:S73-S81.
6. Ives DG, Fitzpatrick AL, Bild DE, Psaty BM, Kuller LH, Crowley PM, et al. Surveillance and ascertainment of cardiovascular events -The cardiovascular health study-. Ann Epidemiol 1995;5:278-85.
7. Suh I, Chun BY, Park JG, Jeon KH. Development of a model for national cardiovascular disease surveillance. Good Health R & D Project, Ministry of Health & Welfare Republic of Korea (1st Year Report), 1999.
8. Thacker SB, Stroup DF, Parrish RG, Anderson HA, Surveillance in environmental public health: Issues, systems and sources. Am J Public Health 1996;86:633-8.
9. Roos JX, Roos NP, Cageorge SM, Nicol JP. How good are the data?-reliability of one health ared data bank. Med Care 1982;20:266-76.
10. Fisher ES, Whaley FS, Kryshat WM, Malenka DJ, Fleming C, Baron JA, et al. The accuracy of Medicare's hospital claims data: progress has been made, but problems remain. Am J Public Health 1992;82:243-8.
11. Lee GS. Diagnosis coding agreement between medical records and medical claim billing data. (A Master's Thesis) Seoul: The Graduate School Seoul National University; 1995.
12. Rawson NSB, Malcolm E. Validity of the recording of ischemic heart disease and chronic obstructive pulmonary disease in the Saskatchewan health care datafiles. Stat Med 1995;14:2627-43.
13. Shin JY. A comparison study of diagnosis code in both medical records and medical claim bills for same discharge patient - Focused on the inpatient 10 frequent diseases - Annual Bulletin of Seoul Health Junior College 1996;16:79-93.
14. Park JG, Kim KS, Kim CB, Lee TY, Lee KS, Lee DH, et al. A nested case-control study on the risk factor of cardiovascular disease in Korean. Good Health R. & D Project, Ministry of Health & Welfare Republic of Korea (1st Year Report), 1998.
15. World Health Organization. Manual of the international statistical classification of diseases, injuries, and causes of death (ninth revision). Geneva: 1977.
16. WHO MONICA Project. Myocardial infarction and coronary deaths in the world health organization MONICA project. Registration procedures, event rates and case-fatality rates in 38 populations from 21 countries in four continents. Circulation 1994;90:583-612.
17. The ARIC Investigators. The Atherosclerosis Risk in Communities (ARIC) Study: Design and objectives. Am J Epidemiol 1989;129:687-702.
18. Luepker RV, Rastam L, Hannan PJ, Murray DM, Gray C, Baker WL, et al. Community education for cardiovascular disease prevention. Morbidity and mortality results form the Minnesota Heart Health Program. Am J Epidemiol 1996;144:351-62.
19. WHO MONICA Project. Mild myocardial infarction. A classification problem in epidemiologic studies. J Clin Epidemiol 1997;50:3-13.
20. Gallum RF, Fortmann ST, Prineas RJ, Kottke TE. International diagnostic criteria for acute myocardial infarction and acute stroke. Am Heart J 1984;108:150-8.
21. Shinar D, Gross CR, Mohr JP, Caplan LR, Price TR, Wolf PA, et al. Inter-observer variability in the assessment of neurologic history and examination in the stroke data bank. Arch Neurol 1985;42:557-65.
22. Moon OR, Kim CY, Kim KM. Individual variations in the code of the international classification of disease for similar outpatient conditions among general practitioners. Korean J Health Policy Adm 1992;2:66-79.
23. Ministry of Health & Welfare Republic of Korea. 1992 Survey Report on the Cancer Patient, 1996.
24. Song YJ. A study on the diagnostic codes' variation of health insurance claim data. (A Master's Thesis) Seoul: Department of Health Administration, The Graduate School of Yonsei University; 1997.
25. Shin EC, Park YM, Park YG, Kim BS, Park KD, Meng KH. Estimation of disease code accuracy of national medical insurance data and the related factors. Korean J Preventive Med 1998;31:471-80.
26. Kim KH, Seo SW, Won SY, Park SG, Kim SY, Song HS, et al. Survey on discordance rate between final principal diagnosis and principal diagnosis at emergency room. Journal of Korean Society Quality Assurance in Health Care 1998;5:216-23.
27. Hsia DC, Krushat WM, Fagan AB, Tebbutt JA, Kusserow RP. Accuracy of diagnostic coding for medicare patients under the prospective-payment system. N Engl J Med 1988;318:352-5.
28. Quam L, Ellis LBM, Venus P, Clouse J, Taylor CG, Leatherman S. Using claims data for epidemiological research: The concordance of claims-based criteria with medical record and patient survey for identifying a hypertensive population. Med Care 1993;31:498-507.
29. Leibson CL, Naessens JM, Brown RD, Whisnant JP. Accuracy of hospital discharge abstracts for identifying stroke. Stroke 1994;25:2348-55.
30. Rosamond WD, Folsom AB, Chambless LB, Wang CH, McGovern PG, Howard G, et al. Stroke incidence and survival among middle-aged adults: 9-year follow-up of the atherosclerosis risk in communities (ARIC) cohort. Stroke 1999;30:736-43.
31. Hsia DC, Ahern CA, Ritchie BP, Moscoe LM, Krushat WM. Medicare reimbursement accuracy under the prospective payment system, 1985 to 1988. JAMA 1992;268: 896-9.