Diagnosis related Group - DRG - Einführung des DRG-basierten Entgeltsystems am Klinikum Hannover

2003 ◽  
Vol 34 (4) ◽  
pp. 207-210
Keyword(s):  
Diagnosis Related Group ◽  
Related Group

scholarly journals Diagnosis-related group-based reimbursement is unrealistic for ICUs

Critical Care ◽  
2009 ◽  
Vol 13 (Suppl 1) ◽  
pp. P485
Author(s):  
A Mclaughlin ◽  
J Hardt ◽  
J Canavan ◽  
MB Donnelly
Keyword(s):  
Diagnosis Related Group ◽  
Related Group

A review of the complexity adjustment in the Korean Diagnosis-Related Group (KDRG)

2018 ◽  
Vol 49 (1) ◽  
pp. 62-68 ◽  
Author(s):  
Sujeong Kim ◽  
Chaiyoung Jung ◽  
Junheum Yon ◽  
Hyeonseon Park ◽  
Hunsik Yang ◽  
...  
Keyword(s):  
Diagnosis Related Groups ◽  
Claim Data ◽  
Hospital Charge ◽  
Diagnosis Related Group ◽  
Cost Data ◽  
Hospital Charges ◽  
Average Charge ◽  
Average Hospital ◽  
Adjustment Mechanism ◽  
Related Group

Background: The Korean Diagnosis-Related Groups (KDRG) was revised in 2003, modifying the complexity adjustment mechanism of the Australian Refined Diagnosis-Related Groups (AR-DRGs). In 2014, the Complication and Comorbidity Level (CCL) of the existing AR-DRG system was found to have very little correlation with cost. Objective: Based on the Australian experience, the CCL for KDRG version 3.4 was reviewed. Method: Inpatient claim data for 2011 were used in this study. About 5,731,551 episodes, which had one or no complication and comorbidity (CC) and met the inclusion criteria, were selected. The differences of average hospital charges by the CCL were analysed in each Adjacent Diagnosis-Related Group (ADRG) using analysis of variance followed by Duncan’s test. The patterns of differences were presented with R 2 in three patterns: The CCL reflected the complexity well (VALID); the average charge of CCL 2, 3, 4 was greater than CCL 0 (PARTIALLY VALID); the CCL did not reflect the complexity (NOT VALID). Results: A total of 114 (19.03%), 190 (31.72%) and 295 (49.25%) ADRGs were included in VALID, PARTIALLY VALID and NOT VALID, respectively. The average R 2 for hospital charge of CCL was 4.94%. The average R 2 in VALID, PARTIALLY VALID and NOT VALID was 4.54%, 5.21%, and 4.93%, respectively. Conclusion: The CCL, the first step of complexity adjustment using secondary diagnoses, exhibited low performance. If highly accurate coding data and cost data become available, the performance of secondary diagnosis as a variable to reflect the case complexity should be re-evaluated. Implications: Lack of reviewing the complexity adjustment mechanism of the KDRG since 2003 has resulted in outdated CC lists and levels that no longer reflect the current Korean healthcare system. Reliable cost data (vs. charge) and accurate coding are essential for accuracy of reimbursement.

scholarly journals Severity variations within DRGs:Measurement of hospital effects by use of data on significant secondary diagnoses

1998 ◽  
Vol 21 (1) ◽  
pp. 37 ◽  
Author(s):  
Don Hindle ◽  
Pieter Degeling ◽  
Ono Van Der Wel
Keyword(s):  
Resource Allocation ◽  
Length Of Stay ◽  
Group Classification ◽  
Public Hospitals ◽  
Diagnosis Related Group ◽  
Use Of Data ◽  
Acute Hospitals ◽  
Related Group

The Diagnosis Related Group classification has provided an excellent basis forenhancing the equity of resource allocation between public acute hospitals. However,it underestimates the higher levels of severity and consequent costliness of referralhospitals.This paper describes a practical way of measuring within-DRG variations in severity,which can be used to increase the precision of casemix-based funding. It involves theregression of length of stay against the numbers of significant diagnoses and procedures,and hence the prediction of additional justified costs. An example is given of itsapplication to data from South Australian public hospitals.

Should Medical Severity-Diagnosis Related Group Classification Be Utilized for Reimbursement? An Analysis of Elixhauser Comorbidities and Cost of Care

2019 ◽  
Vol 34 (7) ◽  
pp. 1312-1316 ◽  
Author(s):  
Sean P. Ryan ◽  
Johannes F. Plate ◽  
Daniel E. Goltz ◽  
David E. Attarian ◽  
Samuel S. Wellman ◽  
...  
Keyword(s):  
Group Classification ◽  
Cost Of Care ◽  
Diagnosis Related Group ◽  
Related Group ◽  
Medical Severity

Diagnosis-Related Group in Colon Surgery: Identifying Areas of Improvement to Drive High-Value Care

2019 ◽  
Vol 85 (3) ◽  
pp. 256-260
Author(s):  
Byron D. Hughes ◽  
Samantha A. Moore ◽  
Hemalkumar B. Mehta ◽  
Yong Shan ◽  
Anthony J. Senagore
Keyword(s):  
United States ◽  
Postoperative Complications ◽  
Best Practice ◽  
Hospital Costs ◽  
Care Program ◽  
Colon Surgery ◽  
Diagnosis Related Group ◽  
Migration Rates ◽  
Related Group ◽  
Value Based Care

Diagnosis-related group (DRG) migration is defined as the reassignment of colectomy patients from DRG 331 to 330 based exclusively on postoperative complications. Strategic and comparative application of this metric has the potential to demonstrate baseline and excessive rates of complications related directly to patient care differences across institutions. The aim of this study was to report the variability of DRG migration across United States hospitals and its impact on overall cost and length of stay (LOS). This study investigated the variability of DRG migration rates across United States hospitals polling 5 per cent of the national Medicare data. The study end-points were total cost, LOS, and DRG migration rate. Hospitals were classified into tertiles for low (0.1–16.6%), moderate (16.7–23.0%), and high (23.1–83.3%) DRG migration rates. The study included 5120 patients from 615 hospitals. DRG migration rates for hospitals ranged from 0.1 per cent to 83.3 per cent, with 157 in the low, 183 in the moderate, and 364 in the high tertile. DRG migration resulted in a progressively increased LOS and hospital costs from the lowest to highest tertile. Several diagnoses were identified which are suggestive of failure to integrate evidence-based processes of care across the tertiles. The data confirm a wide variation in DRG migration rates from DRG 331 to 330 based only on postoperative complications. These ranges allow for the potential definition of both best practice, and opportunities for quality improvement with respect to postoperative complications, identification of hospital outliers, and the economics of care as part of a value-based care program.

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