Case #537

DRG for health care at a distance

Added by Veronika Stemme over 4 years ago. Updated over 3 years ago.

Status:AcceptedStart date:2017-02-20
Priority:MinorSpent time:-
Assignee:Veronika Stemme
Category:-
Target version:Expert Group 2017
Initiator:Sweden Target year:2018
MDC:GEN Owner / responsible:National organisations
Target Grouper:SWE Old forum status:

Description

Problem
The difference between different forms of contacts at a distance gets less and less clear. You can communicate with a doctor or nurse via internet on a computer screen. With a cell phone you can talk, see eachother, send text messages and pictures. At present, the DRG-groups for telephone-contacts include letters and contacts via internet. We suggest that the existing DRG-groups for outpatient care that include contacts at a distance via telephone, letter and internet are kept but with new names that include “at distance”.

Analysis
National Board of Health and Welfare, Sweden, 2017-02-16
This a matter of medical description and no economical analysis is needed.

Suggestion
National Board of Health and Welfare, Sweden, 2017-02-16
The existing groups for telephone-, letter- and internet-contacts are kept but with new names that include “at distance”. The Swedish primary care DRG-groups for internet contacts are deleted.

Decided changes
National Board of Health and Welfare, Sweden, 2017-02-16
We want the changes to be implemented in the Swedish NordDRG 2018.

DRG change
The contacts with patient by telephone, letter or internet will still be grouped to the same DRG-groups as before (DRG-groups for telephone-contacts include letters and contacts via internet) but the names of the groups will be changed to names including that the contact is “at distance”.

Technical change
A new proc pro 99V23 ‘Distance healthcare’ is introduced.
The proc pro 40V42 ‘Letter or telephone contact’ is deleted and the new procpro 99V23 ‘Distance healthcare’ is added for all procedure codes concerning contacts by telephone, letter or internet. The existing DRG-groups for telephone- , letter- and internet-contacts are kept but with new names that include “at distance”.
The Swedish primary care DRG-groups for internet contacts are deleted.

See file: ‘Technical changes CPKID664.xlsx’

Technical changes CPKID664.xlsx (46.2 KB) Veronika Stemme, 2017-02-20 11:35

Technical changes case #537 new.xlsx (310 KB) Martti Virtanen, 2017-05-04 12:08

History

#1 Updated by Veronika Stemme over 4 years ago

  • Description updated (diff)

#2 Updated by Martti Virtanen over 4 years ago

2017-03-13 Expert group
The proposed change was accepted. Affects on NordDRG Swe

#3 Updated by Martti Virtanen over 4 years ago

  • File Technical changes case #537.xlsx added

2017-04-18 Martti Virtanen
The proposed change is technically unnecessary complicated. All interventions with 40V42 are changed to 99V23. The text is changed from 'Letter och telephone contact' to 'Distance healthcare' which in practice is the same thing. The only necessary changes are changes of the names of the property 40V42 and the drgnames.
The additional change in the proposal is removing the specific rules for primary care. This means that the property 97X97 is iactivated and the code(s) will loose that property.
In the logic this means that the rules #00D000340 - #00D000455 and I guess the cases are supposed to be assigned according to the rules with 40V42 (or 99V23). However there are 2157 rules that do not change but may intervene in the assignment. In the technical changes drglogic -sheet i have marked these rows yellow. The question is have you concidered this change?

#4 Updated by Mats Fernström over 4 years ago

Mats Fernström, NPK, Sweden 2017-04-20
Yes, it is possible to make the technical changes in your way but we deliberately want to delete 40V42 and replace it with 99V23. The reason is to get better conformity in the definition data. The KVÅ codes with the present 40V42 are administrative codes for the type of contact and all other administrative codes for type of contact or type of profession have a procedure property beginning with 99V, while KVÅ codes with a procedure property beginning with 40V stand for medical procedures. With our technical changes it will be less hard to understand the Drglogic table and the instructions for the new NDRG Explorer will be less complicated. The instructions for listing the medical procedures that are included in a grouping rule can be written: “Codes with property according to the PROC1 field, except those with a property beginning with 99V”.
We don’t think that removal of the rules for internet contacts in primary care will cause any problems. The cases will be grouped according the existing rules for telephone contacts because they are located in similar positions like the rules for telephone contacts in specialized care. Unfortunately, we are not allowed to collect primary care data in our Patient Register so we cannot make real tests.
Thus we want to stick to our original technical changes. Besides, your technical changes look odd. NCC ID is different in all rows, probably an effect of the autofill function in Excel. More worrying is that you have DRG codes that do not exist in the Swedish version in your Drglogic table, even though it stands “Swe” in the field “nat_ver”.

#5 Updated by Martti Virtanen over 4 years ago

2017-05-04 Martti Virtanen
If you have checked the secondary changes, this is OK.
The DRG-code changes are a misstake I found out somewhat late, they do not affect the grouper but I have now correted them.
40V42=>99V23 change we will do later. But since doing it one by one is tedious and may result in errors I will do it with a programme when I have time (later this year) The Planning version tables may come with 40V42 - sorry for the inonvenience.

#6 Updated by Martti Virtanen over 4 years ago

  • File deleted (Technical changes case #537.xlsx)

#7 Updated by Martti Virtanen over 3 years ago

  • Status changed from Active to Accepted

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