Browsing by Author "Lee, Sangmin"

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    Assessing the performance of a method for case-mix adjustment in the Korean Diagnosis-Related Groups (KDRG) system and its policy implications
    (2021-06-29) Kim, Sujeong; Choi, Byoongyong; Lee, Kyunghee; Lee, Sangmin; Kim, Sukil
    Abstract Background To evaluate the performance of the patient clinical complexity level (PCCL) mechanism, which is the patient-level complexity adjustment factor within the Korean Diagnosis-Related Groups (KDRG) patient classification system, in explaining the variation in resource consumption within age adjacent diagnosis-related groups (AADRGs). Methods We used the inpatient claims data from a public hospital in Korea from 1 January 2017 to 30 June 2019, with 18 846 claims and 138 AADRGs. The differences in the total average payment between the four PCCL levels for each AADRG was tested using ANOVA and Duncan’s post hoc test. The three patterns of differences with R-squared were as follows: the PCCL reflected the complexity well (valid); the average payment for PCCL 2, 3, and 4 was greater than PCCL 0 (partially valid); the PCCL did not reflect the complexity (not valid). Results There were 9 (6.52%), 26 (18.84%), and 103 (74.64%) ADRGs included in the valid, partially valid, and not valid categories, respectively. The average R-squared values were 32.18, 40.81, and 35.41%, respectively, with an average R-squared for all patterns of 36.21%. Conclusions Adjustment using the PCCL in the KDRG classification system exhibited low performance in explaining the variation in resource consumption within AADRGs. As the KDRG classification system is used for reimbursement under the new DRG-based prospective payment system (PPS) pilot project, with plans for expansion, there should be an overall review of the validity of the complexity and rationality of using the KDRG classification system.
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    Development and validation of data quality rules in administrative health data using association rule mining
    (2020-04-25) Peng, Mingkai; Lee, Sangmin; D’Souza, Adam G; Doktorchik, Chelsea T A; Quan, Hude
    Abstract Background Data quality assessment presents a challenge for research using coded administrative health data. The objective of this study is to develop and validate a set of coding association rules for coded diagnostic data. Methods We used the Canadian re-abstracted hospital discharge abstract data coded in International Classification of Disease, 10th revision (ICD-10) codes. Association rule mining was conducted on the re-abstracted data in four age groups (0–4, 20–44, 45–64; ≥ 65) to extract ICD-10 coding association rules at the three-digit (category of diagnosis) and four-digit levels (category of diagnosis with etiology, anatomy, or severity). The rules were reviewed by a panel of 5 physicians and 2 classification specialists using a modified Delphi rating process. We proposed and defined the variance and bias to assess data quality using the rules. Results After the rule mining process and the panel review, 388 rules at the three-digit level and 275 rules at the four-digit level were developed. Half of the rules were from the age group of ≥65. Rules captured meaningful age-specific clinical associations, with rules at the age group of ≥65 being more complex and comprehensive than other age groups. The variance and bias can identify rules with high bias and variance in Alberta data and provides directions for quality improvement. Conclusions A set of ICD-10 data quality rules were developed and validated by a clinical and classification expert panel. The rules can be used as a tool to assess ICD-coded data, enabling the monitoring and comparison of data quality across institutions, provinces, and countries.
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    Pregnant Women with Inflammatory Bowel Disease (IBD) are More Likely to be Vitamin D Insufficient than Pregnant Women without IBD
    (2017) Lee, Sangmin; Seow, Cynthia H.; Kaplan, Gilaad G.; Metcalfe, Amy; Raman, Maitreyi
    Vitamin D insufficiency is associated with adverse pregnancy outcomes. Since individuals with inflammatory bowel disease (IBD) are at risk for vitamin D insufficiency, studying vitamin D status in women with IBD is of importance as the peak incidence of IBD occurs between 18-35 years of age. Currently there is no literature that evaluates vitamin D status in pregnant women with IBD. Therefore, the prevalence of vitamin D insufficiency in pregnant women with IBD was assessed. This study demonstrated that pregnant women with IBD are more likely to be vitamin D insufficient than those without IBD. Further, the current recommended daily dosage of vitamin D supplements for all pregnant women is not appropriate to achieve vitamin D sufficiency, particularly for those with IBD. Appropriate clinical practice guidelines for vitamin D supplementation during pregnancy are needed for optimal prenatal care of pregnant women with IBD to improve their pregnancy outcomes.