OBJECTIVES: In South Korea, health insurance data are used as material for the health insurance of national whole subject. In general, health insurance data could be useful for estimating prevalence or incidence rate that is representative of the actual value in a population. The purpose of this study was to apply the concept of episode of care (EoC) in the utilization of health insurance data in the field of environmental epidemiology and to propose an improved methodology through an uncertainty assessment of disease course and outcome. METHODS: In this study, we introduced the concept of EoC as a methodology to utilize health insurance data in the field of environmental epidemiology. The characterization analysis of the course and outcome of applying the EoC concept to health insurance data was performed through an uncertainty assessment. RESULTS: The EoC concept in this study was applied to heat stroke (International Classification of Disease, 10th revision, code T67). In the comparison of results between before and after applying the EoC concept, we observed a reduction in the deviation of daily claims after applying the EoC concept. After that, we categorized context, model, and input uncertainty and characterized these uncertainties in three dimensions by using uncertainty typology. CONCLUSIONS: This study is the first to show the process of constructing episode data for environmental epidemiological studies by using health insurance data. Our results will help in obtaining representative results for the processing of health insurance data in environmental epidemiological research. Furthermore, these results could be used in the processing of health insurance data in the future.
Classification ; Epidemiologic Studies ; Epidemiology* ; Episode of Care ; Heat Stroke ; Incidence ; Insurance, Health* ; Korea ; Prevalence ; Uncertainty

OBJECTIVES: In South Korea, health insurance data are used as material for the health insurance of national whole subject. In general, health insurance data could be useful for estimating prevalence or incidence rate that is representative of the actual value in a population. The purpose of this study was to apply the concept of episode of care (EoC) in the utilization of health insurance data in the field of environmental epidemiology and to propose an improved methodology through an uncertainty assessment of disease course and outcome. METHODS: In this study, we introduced the concept of EoC as a methodology to utilize health insurance data in the field of environmental epidemiology. The characterization analysis of the course and outcome of applying the EoC concept to health insurance data was performed through an uncertainty assessment. RESULTS: The EoC concept in this study was applied to heat stroke (International Classification of Disease, 10th revision, code T67). In the comparison of results between before and after applying the EoC concept, we observed a reduction in the deviation of daily claims after applying the EoC concept. After that, we categorized context, model, and input uncertainty and characterized these uncertainties in three dimensions by using uncertainty typology. CONCLUSIONS: This study is the first to show the process of constructing episode data for environmental epidemiological studies by using health insurance data. Our results will help in obtaining representative results for the processing of health insurance data in environmental epidemiological research. Furthermore, these results could be used in the processing of health insurance data in the future.
Classification ; Epidemiologic Studies ; Epidemiology* ; Episode of Care ; Heat Stroke ; Incidence ; Insurance, Health* ; Korea ; Prevalence ; Uncertainty

To identify the factors related to the readmission and ambulatory visit we analyzed the data in discharge abstract DB(DADB) and outpatient database(OPDB) for 19,983 patients discharged in 1990 from an university hospital(S Hospital) in Seoul. The target patients were limited to those who didn' t have previous episode of discharge in that hospital. Readmission data for 10 years(1990-1999) and ambulatory visit data for 5 years(1995-1999) were analyzed by using x2 test and multiple logistic regression analysis. The main results of this study is as follows. 1) As the number of readmission was increased, readmission rate(RR) was also increased while the average length of stay(ALOS) was decreased. 2) RR was higher in male, transferred from other health care facilities, with consultation, biopsy, ICU care episode during hospitalization. 3) In logistic regression, RR of patients living close to S Hospital hospital was higher than the others wh?n other variables were adjusted. 4) RR of the patients with the diagnosis(Dx) of cancer or cancer related condition was the highest(47.6%), and the consistency rate (CR) of principal Dx group with that of previous admission was also the highest in cancer patients. As the number of readmission was increased the CR of Dx group was also increased. 5) 23.4%(4866) of the target patients had episode of visiting outpatient dispensary(OPD) for between 1995-1999 and the average number of visit was 13.6 times. Patients with the Dx of heart disease showed the highest proportion in ambulatory visit.
Biopsy ; Delivery of Health Care ; Episode of Care ; Heart Diseases ; Hospitalization ; Humans ; Logistic Models ; Male ; Outpatients ; Patient Care* ; Seoul