Development of the Korean Patient Safety Incidents Code Classification System

Abstract

Objectives: Attempts to understand patient safety using administrative data in Korea have been rare. This study develops a Korean patient safety incident code classification system and identifies its characteristics to boost diagnosis code usage for assessing patient safety.Methods: Based on existing literature, we selected Korean Standard Classification of Diseases 7 codes for characterizing patient safety incidents using diagnosis codes. We conducted 2 rounds of review to evaluate the codes applicability to different patient safety incidents using the Delphi method. The verified diagnosis codes were then classified by incident type.Results: Of the 54,259 Korean Standard Classification of Diseases 7 codes, 4509 were applicable for Korean patients, which were divided into 2435 code groups and 2074 candidate groups. The codes were classified into 6 categories (diagnosis, medication, patient care, operation or procedure, infection related, and other) and then further classified into 35 subcategories. The major categories of patient safety incidents, in the order of frequency, involved medication, fluid and blood related (1719, 38.1%), operation and procedure related (1339, 29.7%), and patient care related (991, 22.0%). Meanwhile, there were only 2 codes related to diagnosis. Conclusions:Our study provides a basis for estimating patient safety incidents using diagnosis codes. We suggest that gradually increasing the utilization and accuracy of the patient safety incident codes will help develop effective patient safety indicators in Korea similar to other countries. Moreover, clinicians are also needed to be aware of using the developed code classification system.

Accuracy assessment of patient safety incident (PSI) codes and present-on-admission (POA) indicators: a cross-sectional analysis using the Patient Safety Incidents Inquiry (PSII) in Korea

“…We noted higher accuracy rates in AEs related to surgery/procedure and infection. The absence of PSI codes in diagnosis-related AEs might be understandable given the limited number of PSI codes—only two—available in the Korean Patient Safety Incidents Code Classification System [ 9 ]. Nonetheless, the lack of codes for patient care-related AEs (such as pressure ulcers)—despite the presence of specific codes like L890 (Stage I decubitus ulcer and pressure area) and L891 (Stage II decubitus ulcer and pressure area)—highlights significant oversight.…”

“…We identified PSI codes using the Korean Patient Safety Incidents Code Classification System [ 9 ]. This system was developed by reviewing and categorising the KCD-7 codes using the Delphi method.…”

“…In this context, attempts have been made to develop a PSI code classification system aimed at systematically and comprehensively gathering data on PSI cases via diagnosis codes [ 8 , 9 ]. For instance, Choi et al [ 9 ] classified a total of 4,509 codes from the Korean Standard Classification of Disease, Version 7 (KCD-7) into six types of PSIs. However, to distinguish the occurrence or prevalence of PSIs, a metric known as present-on-admission (POA) is needed in addition to PSI-related diagnosis codes.…”

Ensuring Patient Safety in Pediatric Dental Care

“…In recent years, awareness of patient safety has increased in Korea, with growing interest from the government and healthcare institutions [5,6]. Nonetheless, there may still be inadequacies compared to global standards [7]. This review aims to address patient safety issues by reviewing the latest patient safety policies of the American Academy of Pediatric Dentistry (AAPD) [8], safety toolkits [9], and pediatric dental residency programs [10].…”