Case #268

Task #11: Delivery of minor update proposals for NordDRG 2015

The hierarchy of DRG 119

Added by Anonymous over 5 years ago. Updated over 4 years ago.

Status:AcceptedStart date:2014-02-24
Priority:MinorSpent time:-
Assignee:-
Category:-
Target version:Expert Group 2014
Initiator:Norway Target year:2015
Case type: Owner / responsible:Nordic Casemix Centre
MDC:MDC05 Old forum status:
Target Grouper:

Description

Forum ID: If known (i.e. in reactivation of an old case)
National ID: HD-0076
Initiated: 2014-02-21
Initiator: Stavanger University hospital

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Problem

Cases with dx code I83.2 ‘Varicose veins of lower extremities with both ulcer and inflammation”as a secondary diagnose, will together with diagnosis and procedures which should have grouped to DRG 479 ‘other vascular procedures w/o cc’ now group to DRG 119 ‘Vein ligation & stripping’. This is due to the hierarchy, where DRG 119 is placed before DRG 478, DRG 479 and DRG 114.

Analysis

Norwegian directorate of health – 2014-02-21

In 2014, following cost weights are calculated for a selection of DRG’s in MDC 05:

Suggestion

Norwegian directorate of health – 2014-02-21

Technical change

We suggest that DRG 119 and 119O are moved below DRG 114, DRG 478, 479 and 479O in the hierarchy.

DRG change

The cases with dx code I83.2 as a secondary dx together with dx/procedures grouping to DRG 479 will move from DRG 119 to DRG 114, DRG 478, 479 or 479O.

2014-02_Norway_update_proposal_2.jpg (11.6 KB) Anonymous, 2014-02-27 10:47

History

#1 Updated by Anonymous over 5 years ago

  • Parent task set to #11

#2 Updated by Martti Virtanen over 5 years ago

2014-03-13 Martti Virtanen
This is a hierarchy problem that cannot be solved by hierarchy change!
The hierarchy is this way because the same codes can be performed as varicose vein operations or with something else. In the latter case they are more expensive. To detect the cheaper varicose vein interventions we use the diagnosis property 05X21 with the result described above. If we change the order as proposed the varicos vein operations will disappear totally.

If this is a problem, we need to list the indications of the more severe situations and create a rule based on them. This probably more complicated.

#3 Updated by Anonymous about 5 years ago

Comment Expert Group 2014-03-24

Suggestion is to postpone the case to 2016.

Further analysis is necessary on how assignment of other than pure varicose vein therapy cases to this low resource DRG can be avoided.

A possibility could be that this rule would be based on principal diagnosis property instead of diagnosis property as currently. Then only cases with principal diagnosis of varicose veins would be assigned to DRG 119 and 119O.

This effect on DRG assignment can be analysed by Norway but since cost analysis is probably also necesary either Sweden or Finland should also test the new model.

#4 Updated by Martti Virtanen about 5 years ago

  • Description updated (diff)

#5 Updated by Anonymous over 4 years ago

  • Status changed from Active to Accepted

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