Disease coding errors by health care organizations: effects of a government quality intervention.
Disease coding errors in claims data can cause serious problems for financing, reimbursement systems, public health surveillance and health research. This study analysed a government intervention to improve coding accuracy of health care organizations in South Korea. The intervention was implemented in 1997 by 226 organizations that had submitted erroneous claims in 1996 for five selected diseases. In 1998, 94% of these organizations eliminated coding errors for these diseases. Those organizations least responsive to the intervention were tertiary hospitals, those publicly owned, and those with other complex organizational characteristics. Overall, this simple intervention appeared extremely effective, and wider adoption of such techniques should be explored.
Shin
Euichul
E
Department of Preventive Medicine, College of Medicine, Catholic University of Korea 505, Banpo-Dong, Socho-Ku, Seoul 137-701, Korea. eshin@cmc.cuk.ac.kr
Dow
William H
WH
Kaluzny
Arnold D
AD
Park
Yong-Moon
YM
Park
Kidong
K
D003141:Communicable Diseases / Q000145:classification*; D018563:Disease Notification / Q000592:standards*; D017598:Efficiency, Organizational; D005568:Forms and Records Control / Q000592:standards*; D006291:Health Policy; D006801:Humans; D007344:Insurance Claim Reporting / Q000145:classification / Q000592:standards*; D007345:Insurance Claim Review; D007349:Insurance, Health, Reimbursement; D038801:International Classification of Diseases; D007723:Korea / Q000453:epidemiology; D011159:Population Surveillance; D015397:Program Evaluation; D011786:Quality Control