Diagnosis Related Groups in Europe: Uses and Perspectives by Francis H. Roger France (auth.), Dr. med. Mercè Casas M.D.,

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By Francis H. Roger France (auth.), Dr. med. Mercè Casas M.D., Ph.D. in Medicine, Dr. Miriam M. Wiley M.Sc., Ph.D. (eds.)

When John Thompson and that i first begun speaking approximately discovering the way to degree and price the output of hospitals within the Sixties. we actually had no notion of the necessity for this type of consequence. in reality. if we had listened to others within the well-being companies study group. we'd rrever have started or endured within the job. however it appeared very important to us to start to appreciate what up till then appeared unexplainable - the fairly unusual expense habit of hospitals. We had the good thing about Professor Martin Feld­ stein's remark that case-mix was once definitely an immense issue. yet we had actually no tips on the best way to make a few feel out of the very huge variety of health problems that beset the human race. and the very huge variety of various strategies that receive in our hospitals as they try and focus on these health problems. We have been lucky to discover a small variety of curious and able graduate scholars to hitch us during this attempt. for with no them we might no longer have had an opportunity of good fortune. whereas many contrib­ uted to the final word consequence. it is very important unmarried out Ronald E. generators. Richard F. Averill. Youngsoo Shin. and Jean L. Freeman for his or her efforts over decades. The diagnosis-related teams (DRGs) represent a manner of choosing the traditional output of hospitals in a constant and exhaustive manner.

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Sample text

Patients nonnally admitted for transurethral prostatectomy are assigned to DRGs 306,307,336, and 337. 4 days. Medical patients who were assigned to DRG 468 as a result of a transurethral prostatectomy had an average LOS of nearly Table 2. 42 11335 7522 15818 9305 5060 10 416 8192 8110 17168 36 Thomas E. McGuire 18 days which is approximately the same as would be expected for the remaining DRG 468 population. Such patients do, however, form a medically interpretable group. Statistics that show the distinct nature of the new groups formed from DRG 468 are illustrated in Table 2.

Eleven new HIV diagnosis codes were created. Both the complexity and/or comorbidity (CC) list and the operating room (OR) procedure list were modified by additions and deletions. Thus, both levelland level 2 changes were made. 0 (1986-1987) One new DRG was added: 472, "extensive bums with OR procedure". DRG assignment was refined for cases involving replacement of pacemaker pulse generators and additional pacemaker procedures. Assignment to DRG "urinary stones with CC and/or ESW lithotripsy" was modified to include patients older than 69 without CC that previously were assigned to the less costly DRG "urinary stones without CC".

Definitions for lyphoma, nonacute leukemia and acute leukemia medical DRGs were also refined. One new diagnosis code was created, "positive serological or viral cultural findings for HN". Thirty-two new procedure codes were created, including: cochlear prosthetic, valvuloplasty, angioplasty, cardioverter/defibrillator, pylorus dilation, gastric bubble, biliary tract, pancreatic, nephrostomy, urinary sphincter and intervetebral disc procedures. Three OR procedures were redefined, including: aorta and thoracic vessel resection and replacement; and insertion of noninflatable penis prosthetic.

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