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Disease coding errors by health care organizations: effects of a government quality intervention
Authors:Shin Euichul  Dow William H  Kaluzny Arnold D  Park Yong-Moon  Park Kidong
Institution: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
Abstract: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.
Keywords:claims data  disease coding  health care organizations  public health surveillance
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