Case #630

Surgery - short therapy

Added by Kristin Dahlen over 1 year ago. Updated 7 months ago.

Status:AcceptedStart date:2019-02-14
Priority:MinorSpent time:-
Assignee:Kristin Dahlen
Category:-
Target version:Target version 2019
Initiator:Norway Target year:2019
Case type:Minor Owner / responsible:National organisations
MDC:GEN Old forum status:
Target Grouper:NOR

Description

From 2018, selected DRGs with equal procedures and where the patients are comparable (short length of stay) provide the same activity-based reimbursement regardless of whether the patient is being treated as an outpatient or is admitted overnight. The purpose of this change is to support the objective of less variation in the proportion of day surgery between hospitals by reducing the incentive to make the patients stay overnight.

We have not made any technical changes to the DRGs, as we have maintained the DRGs for day surgery. A DRG change by grouping both short therapy and inpatients in the same DRG have though been discussed.

This case is mainly reported as information to other countries, but we also appreciate any comments you might have on this issue.

Technical changes case #630.xlsx (308 KB) Martti Virtanen, 2019-03-27 16:36

History

#1 Updated by Ralph Dahlgren over 1 year ago

2019-02-15 Ralph Dahlgren
This sounds also as a good idea as a principle. Since you in Norway has looked inte this we in Sweden do not need no Technical Changes. But we would like to see a list of the DRG that you have been looking at to be able to look and compare with Swedish data. This way we can see if we can do something similar in Sweden.

#3 Updated by Martti Virtanen over 1 year ago

  • File Technical changes case #630.xlsx added

2019-03-06 NCC (MV)
A simple way to solve the proposed grouping is to change the limit of lenth of stay (LOS) of short therapy for surgical groups to <3 days (LOS= day of discharge - day of admission +1)
The attached Technical changes document illustrates the content of the modified rows.
Inpatient care for these groups would then mean at least 2 nights at hospital.

#4 Updated by Martti Virtanen over 1 year ago

2019-03-11 Expert group
Expert accepted that Norway may use specific rules. NOrway has to specify the changes they need as technical changes.

The technical changes was not the correct version. It is now updated.

#5 Updated by Martti Virtanen over 1 year ago

  • File deleted (Technical changes case #630.xlsx)

#6 Updated by Martti Virtanen over 1 year ago

  • Status changed from Active to Further active

#7 Updated by Kristin Dahlen 7 months ago

To Martti's comment on the length of stay (20190306). Before doing this we did discuss whether we should do a major change to put the day surgery together with the short inpatient stays, or to just merge some of the daysurgery DRGs totally with the outpatient DRGs. For the time being we do not want to do that kind of major change in the DRG-system. This might be a development work to consider in the expert group more as a new principle in the future?

As to the technical changes and the discrepancies between the Norwegian made DRG-logic and the version created by the centre, we have a dialogue with Martti and Kristiina.

#8 Updated by Martti Virtanen 7 months ago

  • Status changed from Further active to Accepted

2020-03-09 Expert group
Expert group was informed about the case.
We need to line the Norwegian and Nordic Nor version of NordDRG for future work.
The case is closed now.

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