Case #178

Updated by Anonymous about 7 years ago

Last updated: 2011-04-20
Status: CLOSITEM - Closed item
Initiated: 2009-06-11
By: Liselotte Säll/ Ralph Dahlgren, CPK, Sweden
Expert Network 2010-03-12 - Postpone recommended
Board 2010-04-09 - Recommendation accepted
Expert Network 2011-03-17 - Proposal rejected
Board 2011-04-04 - Recommendation accepted

*BACKGROUND*

CPK ID 318

*Problem*

Diabetes patients have in NordDRG 2009 a different grouping that will lead them to MDC 10 as decided in Case 2009-MDC10-01 [[http://documents.norddrg.net/issues/180]]. 2009-MDC10-01. The Swedish analysis for that case, performed on cost data from 2007, showed that diabetic patients >35 years with vascular disorders (diabetes cases in DRG 130 and 131) or kidney disorders (diabetes cases in DRG 331) were much more expensive than other diabetic patients. This new case is to see if there is a need for a new DRG in MDC 10 for patients >35 years with complicated diabetes.

*Analysis*

The analysis was performed on Swedish cost data from 2007 and 2008. In this material the diabetic patients with organ complications are still found in MDC 01, 02, 05 or 11 since the change decided according to Case 2009-MDC10-01 was introduced 2009.
The tables below show that diabetic patients with organ complications are more expensive than other patients in DRG 294, with the exception for patients with eye complications.

!2010-MDC10-01_01.jpg!

*Suggestion*

A split of DRG 294 in two groups, one for patients with neurological, vascular or nefrological complications (294A) and one for the rest (294B). With the Swedish cost data such a split will be like the table below. Other complicated cases can of course be added to DRG 294A in the future.

!2010-MDC10-01_02.jpg!

*COMMENTS*

*Expert Network 2010-03-12*

The meeting recommended postpones the case to await and see the result of the work with the new CC-logic.

*Expert Network 2011-03-17*

The meeting recommended rejecting the proposal.

The case will be closed.

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