Case #669

Change of grouping the hemodialysis cases with main diagnosis from MDC10 from DRG 810O to 317O

Added by Elina Hermiö about 1 month ago. Updated 4 days ago.

Status:ActiveStart 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:

Description

Problem
Currently the cases having main diagnosis from MDC10 and procedure code with property 11S09 Dialysis, are grouped into DRG 810O Non-extensive procedures of endocrine, nutritional & metabolic disorders, short therapy. Those cases do not fit to DRG 810O in terms of cost and should be rather be grouped into DRG 317O Admit for renal dialysis, short therapy.

Analysis
For analysis, the data of five Finnish university was used from year 2018. The cases having procedure code with PROCPR 11S09 were separated from DRG 810O.
The analysis shows that Hemodialysis cases within 810O are cheaper (402 EUR vs 315 EUR) and fit better to DRG 317O (mean cost 290 EUR).
Regrouped cases into DRG 317O create a homogenous group with mean cost 291 EUR and V% 76%.
DRG 810O remains very heterogenous group and needs additional analysis.

Suggestion
Based on the analysis, we suggest the short therapy cases with main diagnosis from MDC10 and procedure code with property 11S09 Dialysis will group into DRG 317O.

DRG change
After the suggested changes the MDC10 cases with hemodialysis will be grouped into DRG 317O. In definition tables an additional rule (110D109992) will be added above the current rule (110D109990) of DRG 810O and this will be complemented by PROCPR 11S09.

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_6.2-Appendix2.Hemodialysis_cases_from_810O_to_317O.xlsx (20.1 KB) Elina Hermiö, 2020-01-27 14:16

FIN_6.1-Appendix1.Hemodialysis_cases_from_810O_to_317O.xlsx (9.51 KB) Elina Hermiö, 2020-01-27 14:16

History

#1 Updated by Mats Fernström 17 days ago

Mats Fernström, the National Board of Health and Welfare, Sweden
Swe ID C827.
We have a similar problem in the Swedish version so we support this suggestion, but with a small modification. There are more than 500 diagnosis codes in MDC 10 and in the majority of these conditions it is not indicated to give dialysis. Therefor we suggest that the suggested rule 110D109992 is modified so that MDC = 10 is deleted and instead PDGRO 11P01 is inserted in the appropriate column. PDGRO 11P01 ‘Diabetes complicating urinary system’ was introduced last year and the codes with 11P01 are:
E1020 Insulin-dependent diabetes mellitus with renal complications
E1120 Non-insulin-dependent diabetes mellitus with renal complications
E1220 Malnutrition-related diabetes mellitus with renal complications
E1320 Other specified diabetes mellitus with renal complications
E1420 Unspecified diabetes mellitus with renal complications
SWE har subcodes!

#2 Updated by Kristiina Kahur 4 days ago

Finnish National DRG-Centre/Kristiina Kahur 24-2-2020

Finland supports this modification.

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