Case 2013-MDC14-03 Procedures for ectopic pregnancy, short therapy - few cases and small difference to inpatients
|Target version:||Expert Group 2013|
|Case type:||Major||Owner / responsible:||National organisations, Nordic Casemix Centre|
|MDC:||MDC14||Old forum status:||CLOSITEM - Closed item|
Last updated: 2013-04-24
Status: CLOSITEM - Closed item
Initiator: Helsinki University Hospital
Responsible at NPK: Kristiina Kahur, Minna-Liisa Sjöblom
Sent to NordDRG Forum (date): 27.1.2013
Expert Network 2013-03-12 Change recommended
Board 2013-03-27 Change accepted
Finnish national DRG-center got several proposals from Helsinki University Hospital with respect that DRGs in MDC 14 should be revised and analyzed. The main problem was related to DRG 373 also other groups were considered problematic.
During several meetings a working-group of clinical and economical experts was revised all DRGs in MDC 14 and came up with 6 proposals.
The analysis was performed on cases in MDC 14 in a combined data from year 2011 in all five Finnish university hospitals. For grouping Finnish 2011 Full version was used, in case of DRG 379 CC-grouper was used.
Assigning DRG 378O cases to DRG 378N
DRG 378O 'Procedures for ectopic pregnancy, short therapy' has few cases (N=28 in 2011 in Finland) and the difference of cost to DRG 378N 'Operation for ectopic pregnancy' is small. The criteria for independent DRG are not fullfilled. Therefore we suggest these groups should be combined to DRG 378N 'Intervention in ectopic pregnancy'.
Swedish comments 2013-03-07
We do not support this suggestion. There are not many outpatients with DRG P10O/378O in Sweden either (only 8 in the KPP database 2011) but we do not want to mix inpatients and outpatients in the same DRGs. We therefor want to investigate another solution, namely a merging of the DRGs P10O/378O and P11O/377O (Obstetriska problem med andra operationer i öppenvård) and perhaps also O39O/365O (Andra gynekologiska operationer, öppenvård). We have not had time to do such an analysis yet, however.
Expert group – 2013-03-12
The expert group did not recommend any change because there is a resistance to combine short therapy outpatient cases with inpatient cases although in this case the cost difference of outpatients and inpatients is much less at least in Finnish data. The difference is however larger in Swedish data where only outpatient clinic patients are included in the short therapy group.
Board meeting - 2013-03 27
Finland proposed that the Swedish proposal of combining 378O/P10O with 365O/O39O is done for NordDRG 2014. The board accepted this proposal.
Mats Fernström – 2013-03-27
The Swedish data indicate that the proposed change can be accepted also according to Swedish data.
Martti Virtanen - 2013-04-24
Original misunderstanding was corrected (378O is combined with 365O not with 377O as was previously stated above)
DRG 378O (P10O) is combined to DRG 365O (O39O)
In the current rule for DRG 378O (100D700020) DRG is changed to 365O.
The name and code of DRG 365O are not changed.