Case 2012-GEN-01 Revision of CC-properties based on Swedish CC-project
|Target version:||Expert Group 2012|
|Initiator:||Finland, Sweden||Target year:||2012|
|Case type:||Major||Owner / responsible:|
|MDC:||CC||Old forum status:||CLOSITEM - Closed item|
|Target Grouper:||COMMON, DEN, EST, FIN, ICE, LAT, NOR, SWE|
Last updated: 2012-03-19
Status: CLOSITEM - Closed item
By: Martti Virtanen, Nordic Casemix Centre/Mona Heurgren, National Board of Health and Welfare, Sweden
Expert Network 2012-03-08 - Change recommended
Board 2012-03-19 - Recommendation accepted
Sweden has developed a new version of NordDRG with a set of new rules for cases with complications and comorbidities. The model includes two levels of CC-groups Major CC and normal CC. This model is based on the public American DRG. The Swedish work has been represented for the Nordic Casemix centre Expert group several times.
The list of complicating diagnosis was adapted to ICD-10 and tested with Swedish data. Diagnosis that did not exist in Swedish data (mainly tropical infections) was accepted as in the US system.
The testing proved that a number of diagnoses that have belonged to CC-categories based on the old HCFA definition and never tested with Nordic data were not causing increased resource use. Main part of the new MCC categories were confirmed to be associated with increased resource use.
For 2012 a new NordDRG SWE CC version was created and will be used in large proportion of Swedish hospitals. In 2013 Sweden is planning to use only the new CC-grouper.
The proposed change
The attached list shows the changes of complication categories of the WHO ICD-10 codes used in NordDRG. They can be mapped to the national versions of ICD-10. There are 778 dx that previously did not belong to any CC-category and now belong to one (marked “new”). Out of these 150 belong to a major CC-category (xxGxx). Additionally 32 codes have been moved from a conditional CC-category (xxIxx) to an unconditional (xxCxx or xxGxx). 50 codes have been removed from their CC-category. 10 codes have been moved from a CC-category to another.
It will be in practice very difficult to maintain the different CC-categories for the different NordDRG versions. This work is not part of the new agreement of NordDRG maintenance with Datawell Oy. In the longer run other countries should adopt the new CC-grouper including the new MCC-groups. However, if this is not possible for 2013 versions of NordDRG the CC-categories should be replaced with the new list according to the attached list of changes. The groups and the logic can be retained as they are until a change is prepared on national level.
Compared with the original CC-categories of NordDRG the new list is tested with Nordic data and proven to work.
Expert Network 2012-03-08
Martti informed that the current Compl files have not been checked before. These files were checked while constructing the CC-grouper. During the work some American codes were discovered, which not were accepted by ICD-10, that problem has been corrected
The centre support that all Nordic countries should use the new Compl file that the CC-grouper use. There are not enough of resources to maintain two different Compl files of NordDRG, so the CC-grouper’s should be used in all Nordic countries.
The case will be postponed in two weeks. Norway and Finland want check that the CC-Compl file doesn’t affect their hospital budgets to much.
Board meeting 2012-03-19
All countries accepted that the new list of complication categories will be used in all versions of NordDRG 2013.
Fredrik Hanssen 2012-06-01
Norway has realized that the change caused by this case will affect too many cases and since there is no cost per patient data available for Norway the effect cannot not be predicted. Norway wants keep the old list for 2013. This was agreed with Nordic Casemix Centre to be done as a special service for Norway by Centre staff.