Case #63

Case 2013-MDC14-04 - Splitting DRG 379 'Threatend abortion'

Added by Anonymous over 7 years ago. Updated about 7 years ago.

Status:AcceptedStart date:2013-01-27
Priority:MajorSpent time:-
Assignee:Kristiina Kahur
Category:-
Target version:-
Initiator:Finland Target year:2014
MDC:MDC14 Owner / responsible:National organisations
Target Grouper: Old forum status:

Description

Initiated:2011
Initiator: Helsinki University Hospital

Expert Network 2013-03-12: No change recommended, further work needed
Board 2013-03-27: No Change


Problem

Finnish national DRG-center got several proposals from Helsinki University Hospital with respect that DRGs in MDC 14 should be revised and analyzed. The main problem was related to DRG 373 also other groups were considered problematic.

During several meetings a working-group of clinical and economical experts was revised all DRGs in MDC 14 and came up with 6 proposals.

Analysis

The analysis was performed on cases in MDC 14 in a combined data from year 2011 in all five Finnish university hospitals. For grouping Finnish 2011 Full version was used, in case of DRG 379 CC-grouper was used.

Suggestions:

Splitting DRG 379

In DRG 379 Threatened abortion, the cost of the cases differ remarkable depending on the length of stay. At the same time the cost also differ depending on presented complications and comorbidities. The analysis was conducted based on these two different indicators. We observed that the difference between cases with LOS ≤5 and >5 is remarkable. However the variation coefficient in first case is unacceptably high.

Therefore the further analysis was carried out and the influence of LOS within DRG 379N and 379C measured.

As a consequence we present the results to NCC for further discussion in expert network regarding possible changes in grouping logic.

Comments

Swedish comment 2013-03-07

It is natural that cases with longer hospital stay are more expensive than those with a shorter stay, and that can surely be observed in many DRGs, especially in conservative groups. We do not support a DRG split based on LOS however, because that is against common DRG principles. The cases with longer stay often also have secondary diagnoses with CC so a CC split is more appropriate in the DRG system. Furthermore, a very long hospital stay often ends up as a cost outlier.

Expert group – 2013-03-12

The expert group is in principal against creating length of stay based limits to NordDRG although a few exist. However, the problem is common to all countries and a need for improvement of the grouping is obvious. Further analysis is necessary. A new working group is needed? The case was postponed.

Comments

Comment Finnish National DRG Centre Kristiina Kahur / Minna-Liisa Sjöblom 2014-02-18:

After having reviewed and analysed the case we decided not to go on with further analysis and suggest closing the case.

table11.jpg (45.1 KB) Anonymous, 2013-08-29 08:02

table12.jpg (42 KB) Anonymous, 2013-08-29 08:02

History

#1 Updated by Anonymous over 7 years ago

  • Target version changed from 5 to Expert Group 2013
  • Case type set to Major

#2 Updated by Anonymous over 7 years ago

  • Status changed from Active to Further active

#3 Updated by Martti Virtanen about 7 years ago

  • Status changed from Further active to Active
  • Case type changed from Major to Further active
  • Initiator Finland added

#4 Updated by Anonymous about 7 years ago

  • Priority changed from Normal to 23
  • Target version changed from Expert Group 2013 to Expert Group 2014
  • Start date changed from 2013-08-29 to 2013-01-27
  • Owner / responsible National organisations added
  • Target year 2015 added

#5 Updated by Anonymous about 7 years ago

  • Assignee set to Kristiina Kahur

#6 Updated by Anonymous about 7 years ago

  • Description updated (diff)
  • Status changed from Active to Accepted
  • Priority changed from 23 to Major
  • Case type deleted (Further active)
  • Old forum status deleted (FURTHER ACTITEM - Further active item)
  • Target year 2014 added

#7 Updated by Anonymous about 7 years ago

  • Target version deleted (Expert Group 2014)

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