Communicating about the Middle East respiratory syndrome outbreak to the international community and in-country foreigners, Republic of Korea, 2015

During the Middle East respiratory syndrome (MERS) outbreak in 2015, the Ministry of Health and Welfare (MOHW) of the Republic of Korea provided outbreak information targeting international visitors and foreign residents through multiple channels. The MOHW created a MERS portal website in Korean and English on 10 June 2015; in addition, the existing MOHW website provided English-language press releases beginning 28 May. A toll-free telephone hotline also started service in English on 12 June; it expanded to include 18 other foreign languages on 15 June. This report describes the usage of these multi-language communication channels during this MERS outbreak.

Engaging the international community during the 2015 Middle East respiratory syndrome outbreak in the Republic of Korea

The 2015 Middle East respiratory syndrome (MERS) outbreak in the Republic of Korea, which started with an imported case and spread throughout the country with a total of 186 cases, revealed the vulnerabilities of the health-care system of the country. The situation was compounded by the unique health-care settings in the Republic of Korea, including crowded emergency departments and large numbers of hospital visitors seeking care at multiple hospitals. To assist with the outbreak response, the Ministry of Health and Welfare of the Republic of Korea hosted several international joint missions that provided valuable information and recommendations for MERS control and prevention of future outbreaks. This report briefly summarizes the missions’ outcomes and discusses their positive impacts.

Disability Weights for the Korean Burden of Disease Study: Focused on Comparison with Disability Weights in the Australian Burden of Disease Study / 예방의학회지

OBJECTIVE: This study aimed to measure the disability weights for the Korean Burden of Disease study, and to compare them with those adopted in the Australian study to examine the validity and describe the distinctive features. METHODS: The standardized valuation protocol was developed from the Global Burden of Disease (GBD) study and the Dutch Disability Weights study. Disability weights were measured for 123 diseases of the Korean version of Disease Classification by three panels of 10 medical doctors each. Then, overall distribution, correlation coefficients, difference by each disease, and mean of differences by disease group were analyzed for comparison of disability weights between the Korean and Australian studies. RESULTS: Korean disability weights ranged from 0.037 to 0.927. While the rank correlation coefficient was moderate to high (rs=0.68), Korean disability weights were higher than the corresponding Australian ones in 79.7% of the 118 diseases. Of these, war, leprosy, and most injuries showed the biggest differences. On the contrary, many infectious and parasitic diseases comprised the greater part of diseases of which Korean disability weights were lower. The mean of the differences was the highest in injuries of GBD disease groups, and in cardiovascular disease, injuries, and malignant neoplasm of the Korean disease category. CONCLUSION: Korean disability weights were found to be valid on the basis of overall distribution pattern and correlation, and are expected to be used as basic data for broadening the scope of burden of disease study. However, some distinctive features still remain to be explored in following studies.

Direction of Health Care and Health Insurance System Reform to Strengthen Primary Care: Comparative Analysis of Korea, Japan and Taiwan

BACKGROUND: This study aims to find the direction of health care and health insurance system reform to strengthen primary care in Korea. METHODS: A comparative analysis was performed on health care system and health insurance system between Korea, Japan, and Taiwan. RESULTS: (1) Functional differentiation between the hospital and the clinic is unclear and many clinics run beds for in-patient care. However, Japan and Taiwan have clear rule on the function of the hospital and the clinic, and only temporary observation beds are allowed for the clinic. (2) Health service delivery system is not defined in the Korean Health care Act. However, Japan and Taiwan have rules on health service delivery system in their health care act. (3) The system of co-payment ceiling is operated in Japan and Taiwan, but not in Korea. And Taiwan has various co-payment system including exemption of co-payment to fulfill the mission of health security. (4) Japan and Taiwan have many fee schedules for enforcing primary care, while Korea has little. CONCLUSION: Health care and health insurance system should be reformed in order to strengthen primary care. Most of all, the role of the hospital and the clinic should be classified. Fee schedule for primary care should be changed to encourage coordinated management of chronic diseases. Reform of co-payment system is also required.

Efficient DRG Fraud Candidate Detection Method Using Data Mining Techniques / 예방의학회지

OBJECTIVES: To develop a Diagnosis-Related Group (DRG) fraud candidate detection method, using data mining techniques, and to examine the efficiency of the developed method. METHODS: The study included 79, 790 DRGs and their related claims of 8 disease groups (Lens procedures, with or without, vitrectomy, tonsillectomy and/or adenoidectomy only, appendectomy, Cesarean section, vaginal delivery, anal and/or perianal procedures, inguinal and/or femoral hernia procedures, uterine and/or adnexa procedures for nonmalignancy), which were examined manually during a 32 months period. To construct an optimal prediction model, 38 variables were applied, and the correction rate and lift value of 3 models (decision tree, logistic regression, neural network) compared. The analyses were performed separately by disease group. RESULTS: The correction rates of the developed method, using data mining techniques, were 15.4 to 81.9%, according to disease groups, with an overall correction rate of 60.7%. The lift values were 1.9 to 7.3 according to disease groups, with an overall lift value of 4.1. CONCLUSIONS: The above findings suggested that the applying of data mining techniques is necessary to improve the efficiency of DRG fraud candidate detection.

Disability Weights for Diseases in Korea / 예방의학회지

OBJECTIVES: This study aimed to develop an evaluation protocol of disability weights using person trade-off, and to test the reliability of the developed protocol in a Korean context. METHODS: To develop the valuation protocol, the Global Burden of Disease (GBD) and the Dutch studies were replicated and modified. Sixteen indicator conditions were selected from the Korean version of disease classification, which was based on that of the GBD Study, and the person trade-off method referred to the Dutch method. RESULTS: The disability weights were valued in a two step panel study. The first step was a carefully designed group process by three panels, using person trade-off to establish the disability weights for sixteen selected indicator conditions. The second step consisted of interpolation of the remaining diseases, on a disability scale, by the individual members of three panels. The members of three panels were all medical doctors, with sufficient knowledge of the consequences of a broad variety of diseases. The internal consistency of the Korean disability weights was satisfactory. Considerable agreement existed within each panel and among the panels. CONCLUSIONS: It was feasible to use a modified evaluation protocol from those used in GBD and Dutch studies. This would provide a rational basis for an international comparative study of disability weights.

Incorrect Disease Coding in Medical Insurance Claims and the Effect of Official Intervention: Based on Medical Insurance Claims of 6 Notifiable Acute Communicable Diseases / 한국역학회지

BACKGROUND: Because of their large size and excellent computerized records of illness and services rendered, the importance of national insurance program is getting much attentions from the public health researchers and the national and local health authorities. In reality, however, most health records from medical insurance program suffer very much from inaccurate disease coding, and therefore, they are practically in no use. METHODS: Pattern of incorrect disease coding of 6 Notifiable Acute Communicable Diseases that believed not to have been occurred in Korea lately was reviewed. The reasons of such incorrect codings in different level of medical institutions were studied. This study also attempted to see how an official intervention asking the medical institutions to correct their coding behavior works by comparing the frequencies of incorrect disease coding before and after the intervention. RESULTS: Study results showed that more incorrect disease codings came from clinics than hospitals, and non-physician personnel in clinics and hospitals seemed to be responsible for most of the incorrect disease codings. Most frequent diseases coded incorrectly such as cholera and poliomyelitis were the ones that physicians and non-physician personnel in the clinics and hospitals had been familiar with for a long time period. CONCLUSION: Even a simple official intervention asking the clinics and hospitals to correct their coding behavior was very effective : total number of incorrect disease codings before intervention (398 cases from 144 institutions) dramatically decreased (14 cases from 8 institutions) after intervention. Significant decrease in incorrect disease coding was found more in small institutions such as clinics and public health facilities than large institutions.