Development initiative #74: Development of grouping MDC15 - Newborn
Case 2013-MDC15-01 - Neonates under birth weight less than 1000g in DRG 385B (Follow-up care of neonatal problems or delayed neonatal problem)
|Target version:||Expert Group 2013|
|MDC:||MDC15||Owner / responsible:||National organisations|
|Target Grouper:||COMMON||Old forum status:||ACTITEM - Active item|
Last updated: 2013-03-27
ACTITEM - Active 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 a proposal from Helsinki University Hospital and also from Central Finland Central Hospital that MDC 15 should be analyzed and tested. The working group went through the DRGs in MDC15 and came up with two proposals for change to the grouping logic in some DRGs.
Secondary care of neonates with birth weight less than 1000 g proved to be much more expensive than other neonatal follow-up care (DRG 385B) and thus do not belong to that group neither by resource use nor clincially
For analysis the cases of year 2011 grouped to MDC 15 were used. The data was combined from five Finnish university hospitals as well as from central hospitals. For grouping Finnish 2011 Full version was used.
The neonates with birth weight < 1000 g proved to be much more expensive than other cases in DRG 385B. Also clinically the secondary care is not distinctive from other care of these tiny babies. Therefore they should be assigned to DRG 368N
If the birth weight of a newborn inpatient is under 1000 g (ICD10plus codes P070A, P070B, P070C), the case should always be assigned to the DRG 386N (Neonate, birth weight under 1000 g).
Swedish comment 2013-03-08
Swedish cost data (KPP 2011):
Also in Swedish data, the P070 cases within DRG 385B/Q10N are more expensive than the rest in that group, but they are not so expensive that they fit in DRG 386N/Q15N. Therefore we do not support the suggestion to move the P070 cases within DRG 385B/Q10N to DRG 386N/Q15N. A possible alternative is to let the P070 cases within DRG 385B/Q10N to become a new separate DRG. All criteria for such a split are fulfilled.
Expert group – 2013-03-12
The expert group recommends that a new DRG is created for Follow-up care of neonates with birth weight less than 1000 g.
After care of neonates with birth weight less than 1000 g will be assigned to a new DRG 385C 'Follow-up care of neonates with birth weight less than 1000 g'. The grouping demands that a diagnosis from the P070 group (different in different NordDRG countries) is registered as primary or secondary diagnosis.
A new DRG is created
385C/Q12N? 'Follow-up care of neonates with birth weight less than 1000 g'
The name of the DRG 385B/Q10N will be changed to:
385B/Q10N 'Follow-up care of neonatal problems or delayed neonatal problem, birth weight 1000 g or more'
Two new rules are created immediately before current rule 015D80101 for DRG 385B/Q10N.
The first of these rules is a copy of rule 015D80101 with Dgprop1 given value 15X23 and DRG changed to 385C
The second is a copy of the rule 015D80111 with the same changes as before.