Splitting DRG 020 Nervous system infection except viral meningitis based on CC/non-CC
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DRG 020 is a heterogeneous group (V% 128% in 2017, and 312% in 2016) with different peaks within the group which may refer to problem with clinical or economical meaningfulness within the group.
In order to understand the reasons, an analysis was conducted.
For analysis, the data of five Finnish university was used from years 2015, 2016 and 2017.
To start with, the cases of DRG 020 were separated based on presence/non-presence of secondary diagnoses which have the COMPL property. CC cases were flagged and all cases were divided into two groups: 1) cases with CC and 2) cases without CC.
The homogeneity analysis was conducted in both groups. The analysis showed that the cases flagged with CC were 14-53% more expensive compared to the ones of non-CC.
After trimming 1% of expensive end cases the difference of average cost between CC and non-CC remained between 19-33% (see more precisely Appendix 1).
Trimming also decreased the coefficient of variation in both groups.
Based on the analysis, we suggest splitting DRG 020 into two groups based on presence of CC/non-CC.
After the suggested changes, two new DRGs will be created instead of current DRG 020 as follows:
1) DRG 020A Nervous system infection except viral meningitis, with CC
2) DRG 020B Nervous system infection except viral meningitis, without CC.
Appendix 1. Cost analysis is based on five university hospitals’ data of years 2015, 2016 and 2017, grouped with Finnish 2019 grouper.
Appendix 2. The technical changes may contain mistakes and have to be double-checked.