Limits...
Variation in resource use within diagnosis-related groups: the severity issue.

Smits HL, Fetter RB, McMahon LF - Health Care Financ Rev (1984)

Bottom Line: The limitations of the Uniform Hospital Discharge Data Set (UHDDS), of the International Classification of Diseases, Ninth Revision, Clinical Modification coding system and of the original rules of DRG construction must be evaluated and, if necessary, corrected before new approaches to groupings are considered.The most promising potential modifications of existing groups and weights are those that make use of the UHDDS, or of the UHDDS plus additional diagnoses and procedures.The addition of entirely new data elements to the discharge abstract and the pricing process should be considered only as a last resort.

View Article: PubMed Central - PubMed

ABSTRACT
Several authors have suggested that diagnosis-related groups (DRG's) make inadequate allowance for the severity of illness. Before modifications of DRG's are developed, the sources of within-group variation must be precisely defined; not all variation is attributable to the severity of illness. The limitations of the Uniform Hospital Discharge Data Set (UHDDS), of the International Classification of Diseases, Ninth Revision, Clinical Modification coding system and of the original rules of DRG construction must be evaluated and, if necessary, corrected before new approaches to groupings are considered. The most promising potential modifications of existing groups and weights are those that make use of the UHDDS, or of the UHDDS plus additional diagnoses and procedures. The addition of entirely new data elements to the discharge abstract and the pricing process should be considered only as a last resort.

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Related in: MedlinePlus

Percent distribution of length of stay of patients from Maryland in DRG 39, lens procedures
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Related In: Results  -  Collection


getmorefigures.php?uid=PMC4195103&req=5

f1-hcfr-84-supp-071: Percent distribution of length of stay of patients from Maryland in DRG 39, lens procedures

Mentions: To place the issue of severity in perspective, the other known causes of DRG instability must be considered. If all DRG's from a large data base are plotted and inspected, some groupings appear more cohesive than others. Figure 1 illustrates a typical good, or stable, DRG with a tightly clustered pattern of resource use. Figure 2 shows a relatively unstable DRG which contains more variation. The stable DRG is 39, lens procedures, undertaken in patients judged capable of undergoing elective cataract surgery. The variations in operative approach in use at the time these data were collected had little effect on eventual patterns of resource use. DRG 14, specific cerebrovascular disorder except transit ischemic attack (TIA), by contrast, is much less cohesive. It appears that the patients within this DRG could be subdivided further if appropriate data were available.


Variation in resource use within diagnosis-related groups: the severity issue.

Smits HL, Fetter RB, McMahon LF - Health Care Financ Rev (1984)

Percent distribution of length of stay of patients from Maryland in DRG 39, lens procedures
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4195103&req=5

f1-hcfr-84-supp-071: Percent distribution of length of stay of patients from Maryland in DRG 39, lens procedures
Mentions: To place the issue of severity in perspective, the other known causes of DRG instability must be considered. If all DRG's from a large data base are plotted and inspected, some groupings appear more cohesive than others. Figure 1 illustrates a typical good, or stable, DRG with a tightly clustered pattern of resource use. Figure 2 shows a relatively unstable DRG which contains more variation. The stable DRG is 39, lens procedures, undertaken in patients judged capable of undergoing elective cataract surgery. The variations in operative approach in use at the time these data were collected had little effect on eventual patterns of resource use. DRG 14, specific cerebrovascular disorder except transit ischemic attack (TIA), by contrast, is much less cohesive. It appears that the patients within this DRG could be subdivided further if appropriate data were available.

Bottom Line: The limitations of the Uniform Hospital Discharge Data Set (UHDDS), of the International Classification of Diseases, Ninth Revision, Clinical Modification coding system and of the original rules of DRG construction must be evaluated and, if necessary, corrected before new approaches to groupings are considered.The most promising potential modifications of existing groups and weights are those that make use of the UHDDS, or of the UHDDS plus additional diagnoses and procedures.The addition of entirely new data elements to the discharge abstract and the pricing process should be considered only as a last resort.

View Article: PubMed Central - PubMed

ABSTRACT
Several authors have suggested that diagnosis-related groups (DRG's) make inadequate allowance for the severity of illness. Before modifications of DRG's are developed, the sources of within-group variation must be precisely defined; not all variation is attributable to the severity of illness. The limitations of the Uniform Hospital Discharge Data Set (UHDDS), of the International Classification of Diseases, Ninth Revision, Clinical Modification coding system and of the original rules of DRG construction must be evaluated and, if necessary, corrected before new approaches to groupings are considered. The most promising potential modifications of existing groups and weights are those that make use of the UHDDS, or of the UHDDS plus additional diagnoses and procedures. The addition of entirely new data elements to the discharge abstract and the pricing process should be considered only as a last resort.

Show MeSH
Related in: MedlinePlus