서론 34 2

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1 34 2 Journal of the Korean Society of Health Information and Health Statistics Volume 34, Number 2, 2009, pp HL7 곽정수 1), 채영문 2), 용왕식 1), 김석일 3), 이병화 2) 1), 2), 3) Development of the HL7-based Classification System for the Long Term Care Insurance for the Elderly 1) National Health Insurance Corporation 2) Graduate School of Public Health, Yonsei University 3) Dept. Preventive Medicine, College of Medicine, Catholic University Abstract Objectives: The purposes of this study were to develop the HL7-based Classification System for the Long Term Care Insurance for the elderly in order to reduce classification errors and to reduce variations in classification among rating doctors. Specifically, the classification system was developed for the elderly who were eligible for the Long Term Care Insurance based on HL7 standards and eligibility criteria developed by the National Health Insurance Cooperative (NHIC). Methods: 38 cases that were actually reviewed by rating committee in May 2009 were selected from the classification data submitted to the long term care insurance unit at the D branch of NHIC on HL7. The system was designed by selecting 46 items from health insurance and NHIC criteria and IPI(Insurance Patient Information) message based on HL7 2.5 in order to transmit messages to other institutes. The system was analyzed and designed by DFD(Data Flow Diagram) and HIPO(Hierarchical Input, Process, Output). The system was evaluated through frequency analysis of system environment and rating data after calculating the 2nd grade by operating each module of HL7 message. Results: The results of this research were as follows: 38 cases submitted by doctors were 22 right cases and 16 wrong cases for the physical condition area; 27 right cases and 11 wrong cases in the area of mental state; and 26 right cases and 12 wrong cases in the area of independence of daily life. The number of cases whose grade was changed was 4: 1 case from 4th grade to 3rd grade, 2 cases from 3rd grade to 2nd grade and 1 case from 2nd grade to 1st grade. The cause of functional disorder for changing grade was 3 dementia and 1 bleeding. Conclusions: The model of the HL7-based Classification System for the Long Term Care Insurance for the elderly was designed to reduce classification errors and to reduce variations in classification among rating doctors. After the use of the model system, its usability was assessed. Keywords: Long Term Care Insurance for the Elderly, classification, doctor's rating, medical information, HL7 message *:, ymchae@yuhs.ac 34 2

2 서론 34 2

3 HL 연구방법 2.1 연구대상및범위 2.2 연구분석및방법 (1) HL7 34 2

4 124 (2) HL7 (3) (4) 34 2

5 HL 결과 3.1 HL7기반의료정보 (1) HL7 Figure 1. HL7 34 2

6 126 Table 1. HL7 Table: Relationship Table Type Table Name Reference CH User Relationship ( ) Definition the actual personal relationship that the next of kin / associated party has to th patient( ) Value HL7 Table ASC Associate BRO Brother CGV Care giver CHD Child EXF EXF Extended family FCH Foster child FND Friend FTH FTH Father GCH Grandchild GRO GRD Guardian GRP Grandparent OTH Other OWN Owner PAR Parent SCH Stepchild SEL SEL Self SIB SIB Sibling SIS Sister SPO SPO Spouse 34 2

7 HL7 127 (2) Table 2. HL7 (8 ) (11 ) (27 ) (8 ) (11 ) (11 ) (16 ) (ID),,,,,,, (ID),,,,,,,,,, (ID),,,,,,,,,, (ID),,,,,,,,,,,,,,, 34 2

8 128 (3) HL7 3.2 HL7기반등급판정시스템모형개발 (1) 34 2

9 HL7 129 Figure 2. IPI^E02 Figure 3. System Data Flow (2) 34 2

10 130 Table

11 HL7 131 Table 4. () M00, M01, M02, M03, M05, M06, M07, M10, M11, M12, M13, M14, M15, M19, M21, M24, M86 06, 24, 26 M75 11 M70 12 M18 13 M16, M70, M76 15 M17, M22, M23, M70, M76 19 F00, F01, F02, F03, G20, G21, G22, G23, G30, I60, I61, I62, I63, I64, I65, I66, I67, I68, I69 01, 04, 05, 06, 02.2 Figure 4. HL7 34 2

12 132 (3) HL7 Table

13 HL7 133 Figure HL7 기반등급판정시스템평가 (1) Table 6. HL7 EVN Chameleon E01, E02 IMI (2) 34 2

14 134 Table (%) (%) (%) A Table 8. (%) (%)

15 HL7 135 Table A A (10.5%) 4 (10.5%) 3 (7.9%) 1 (2.6%) Table A A 고찰및결론 34 2

17 HL7 137 참고문헌 Bundesministeriumfür Gesundheit. Zahlen und Fakten zur Pflegeversicherung, Berlin: Bundesregierung; Campbell J, Ikegami N. Designing an independent LTC system: in General and in Japan. Discussion paper; Evers A. The new long-term care insurance program in Germany. Journal of Ageing & Social Policy 1998;10(1). Laing & Buisson. Care of elderly people. Market survey 2001, London. Robinson R, Dixon A. United Kingdom. Health care systems in transition. copenhagen; European Observatory on Health Care 34 2

18 138 Systems; Tokyo Metropolitan Government. Supporting nursing care through society, Long-Term Care Insurance System; Health Level Seven, Inc. Accessed 21 March,

서론 34 2

서론 34 2 34 2 Journal of the Korean Society of Health Information and Health Statistics Volume 34, Number 2, 2009, pp. 165 176 165 진은희 A Study on Health related Action Rates of Dietary Guidelines and Pattern of