Case #667

Split of DRG 296 Nutritional & misc metabolic disorders, age > 17 w cc into CC and MCC groups

Added by Elina Hermiö 5 months ago. Updated 3 months ago.

Status:AcceptedStart date:2020-01-27
Priority:MinorSpent time:-
Assignee:-
Category:-
Target version:-
Initiator:Finland Target year:2021
Case type: Owner / responsible:
MDC: Old forum status:
Target Grouper:EST, FIN

Description

Problem
DRG 296 is a heterogenous group with high V% (168% in 2017, 117% in 2018) and different peaks. The trimming does not improve the situation. To see if the split into CC and MCC groups would be a solution, the respective cost analysis was conducted.

Analysis
For analysis, the data of five Finnish university was used from years 2018 and 2017. All cases grouped into DRG 296 were derived from the data and divided into two groups based on property of secondary diagnoses (CC or MCC).
The analysis shows that there is ca 44% difference in mean cost depending on cc/mcc status (4767 EUR vs 3307 EUR). V% improves after 1% of trimming from higher end.

Suggestion
Based on the analysis, we suggest splitting DRG 296 into two DRGs depending on the secondary diagnosis and COMPL property given to each diagnosis.

DRG change
After the suggested changes two new DRGs will be created: DRG 296C and DRG 296M and cases which previously grouped into DRG 296 will group new DRGs depending on the secondary diagnosis. In definition tables two new rules (410D121001 and 410D121002) will be added for DRG 296C and 296M after the current rule (410D121000) for DRG 296.

Cost analysis
Appendix 1. Cost analysis is based on five university hospitals’ data of year 2018, grouped with FIN 2020PR1 grouper.

Technical changes
Appendix 2.

FIN_4.1-Appendix1.Split_of_296_into_CC_MCC.xlsx (20.4 KB) Elina Hermiö, 2020-01-27 14:11

FIN_4.2-Appendix2.Split_of_296_into_CC_MCC.xlsx (16.8 KB) Elina Hermiö, 2020-01-27 14:11

296_2019_expertgroup.MHT (61.3 KB) Malle Avarsoo, 2020-03-17 11:30

Technical_changes_667_Split_of_296_into_CC_MCC.xlsx (17.1 KB) Kristiina Kahur, 2020-03-20 15:58

Technical_changes_667_2.xlsx (16.8 KB) Kristiina Kahur, 2020-04-14 11:12

History

#1 Updated by Martti Virtanen 4 months ago

  • Status changed from Active to Further active

2020-03-09 Expert group
The proposal was accepted for Fin version. The Swe version is already similar. Other countries may join the model by informing us on this page.
To remind of the possibility we retain this case as further active.

#2 Updated by Malle Avarsoo 4 months ago

Estonia supports this change for EST version.
Figurative data showing the inhomogeneous groups and VI (10,41) for this DRG attached.

#3 Updated by Kristiina Kahur 4 months ago

Nordic Casemix Centre/Kristiina Kahur 20-3-2020

The technical changes are updated and attached to the ticket as Estonia joined and supports this change too.
DRG names in Estonian version are in English at the moment. We are looking forward to receiving the national names.
English ones looks like follows:
296C Nutritional & misc metabolic disorders, age > 17, w cc
296M Nutritional & misc metabolic disorders, age > 17, w mcc

#4 Updated by Malle Avarsoo 3 months ago

EST version names for these DRG-s will be:

296C Toitumis-ja muud ainevahetushäired, vanus >17, kht-ga
296M Toitumis-ja muud ainevahetushäired, vanus >17, oluliste kht-ga

#5 Updated by Kristiina Kahur 3 months ago

Nordic Casemix Centre/Kristiina Kahur, 14-4-2020

This changes was implemented FIN and EST 2021 tables. TC have been updated with EST national names and some error corrections and attached.

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