医疗保险理赔数据作为研究数据源：诊断编码的准确性
Medical insurance claims as a source of data for research: accuracy of diagnostic coding.
作者信息
Worth R M, Mytinger R E
机构信息
Hawaii MEDTEP Research Center, Pacific Health Research Institute, Honolulu 96813, USA.
出版信息
Hawaii Med J. 1996 Jan;55(1):9-11.
PMID:8786232
Abstract
Validation of diagnostic codes in a sample of Hawaii medical insurance claims in 1986 to 1987 revealed 96% accuracy in hospital claims, high enough to supply data for research purposes. In physician claims the accuracy was only 62%. Initiation of two feedback loops to physicians from the insurer in 1989 resulted in a marked improvement of diagnostic coding accuracy by 1992 to 1994.
摘要
对1986年至1987年夏威夷医疗保险索赔样本中的诊断编码进行验证后发现，医院索赔的准确率为96%，高到足以提供用于研究目的的数据。在医生索赔方面，准确率仅为62%。1989年保险公司启动了两个向医生反馈的循环，到1992年至1994年，诊断编码准确率有了显著提高。
Zotero 插件