Case #504

Merging DRG 472O Extensive burns with o. r. procedure, short therapy and DRG 459O Non-extensive burns with wound debridement or other o. r. procedure, short therapy

Added by Kristiina Kahur almost 5 years ago. Updated almost 4 years ago.

Status:AcceptedStart date:2017-01-17
Priority:NormalSpent time:-
Assignee:Kristiina Kahur
Category:-
Target version:Expert Group 2017
Initiator:Finland Target year:2018
MDC:MDC22 Owner / responsible:National organisations
Target Grouper:COMMON Old forum status:

Description

Problem
The number of cases in DRG 472O has been low throughout the years (eight in 2013, four in 2014, 11 in 2015) which was the indication for further analysis of DRG 472O with aim to merge the cases in DRG 472O to another suitable DRG.

Analysis
Given the small number of cases in DRG 472O and fluctuating mean cost ranging between 313 and 9 283 EUR in 2015 (1 483 to 3 560 EUR in 2014), one option is to merge the cases of DRG 472O with those of DRG 459O (Non-extensive burns with wound debridement or other o. r. procedure, short therapy).
Clinically, DRG 472O is meant for extensive burns while DRG 459O for non-extensive ones. Clinical difference should also be expressed by cost data.
When to compare the (untrimmed) mean cost of both DRGs, the cost differences exist to some extent. Nevertheless, after trimming 1% of high-end cases the differences are not remarkable anymore, and in 2014 data the mean cost of extensive burns is even lower than non-extensive one.
The variation coefficient of merged DRGs would remain ca 50%, number of cases 50-60.

Suggestion
Based on the cost analyses we propose to merge DRGs 472O and 459O. The name of the merged DRGs will be provided after the discussions in Expertnetwork meeting.

DRG change
After the suggested change the cases in DRG 472O will be grouped to DRG 459O.

Technical changes
Appendix 2. The technical changes may contain mistakes and have to be used with caution.

Cost analysis
Appendix 1. Cost analysis is based on five university hospital data of 2015, grouped with Finnish 2017 grouper, and data of 2014, grouped with 2016 grouper.

MDC22_Burns_DRG472O+459O_merge_Appendix1.xlsx - Appendix 1 (9.73 KB) Kristiina Kahur, 2017-01-17 10:50

MDC22_Burns_DRG472O+459O_merge_Appendix2.xlsx - Appendix 2 (22.5 KB) Kristiina Kahur, 2017-01-17 10:50

Appendix #504 SWE 2017.xlsx (10.4 KB) Mats Fernström, 2017-03-02 14:43

Technical changes case #504&506.xlsx (88.7 KB) Martti Virtanen, 2017-05-03 14:11

History

#1 Updated by Mats Fernström over 4 years ago

Mats Fernström, NPK, Sweden 2017-03-02 (NPK ID C674)
The corresponding Swedish DRGs are V01O ’Omfattande brännskador, med operation, öppenvård’ and V21O ’Mindre omfattande brännskador, med sårrevision el andra operationer, öppenvård’. We don’t have many cases either in DRG 472O/V01O, in average 35 cases per year 2013-2015 (see Appendix #504 SWE 2017.xlsx) but they are 93-173 % more expensive than the cases in DRG V21O, so from a cost perspective a merging is no good. The second smallest group in this context is DRG 458O/V20O ’Mindre omfattande brännskador, med hudtransplantation, öppenvård’ (Non-extensive burns w shin graft, short therapy) so just looking at volumes a merging of DRG 472O/V01O and DRG 458O/V20O seems as a better alternative but we think that also this difference in average costs (71 %) is too big. Thus, Sweden does not want the suggested change.

#2 Updated by Kristiina Kahur over 4 years ago

Finnish National DRG-centre 2017-3-29

We checked whether there are cases with skin transplantation in DRG 459O. There was not any.
We would like to proceed with the suggested change and introduce it in 2018 Finnish version.

#3 Updated by Martti Virtanen over 4 years ago

2017-03-13 Expert group
The case was postponed for anlysis in Finland and Sweden

#4 Updated by Martti Virtanen over 4 years ago

2017-05-03 Martti Virtanen
As Finland wants a change and Sweden is against it, the change must be done only for Finnish version.
The matter is closely reated to Case #506 and therefore the technical changes are combined.
The change in NordDRG Fin affects the naming of the DRG 459O. This does not affect the national names of the DRG's.

#5 Updated by Martti Virtanen almost 4 years ago

  • Status changed from Active to Accepted

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