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Titolo:
Australian refined diagnosis related groups: problems of grouping and application in stroke care
Autore:
Kugler, C; Freytag, S; Stillger, R; Bauer, P; Ferbert, A;
Indirizzi:
Inst Integrat Versorgung Med GbR, Kassel, Germany Inst Integrat VersorgungMed GbR Kassel Germany ed GbR, Kassel, Germany Univ Bielefeld, Studiengang Angew Gesundheitswissensch, D-4800 Bielefeld, Germany Univ Bielefeld Bielefeld Germany D-4800 ensch, D-4800 Bielefeld, Germany Klinikum Kassel gGmbH, Neurol Klin, Kassel, Germany Klinikum Kassel gGmbHKassel Germany GmbH, Neurol Klin, Kassel, Germany
Titolo Testata:
DEUTSCHE MEDIZINISCHE WOCHENSCHRIFT
fascicolo: 51-52, volume: 125, anno: 2000,
pagine: 1554 - 1559
Fonte:
ISI
Lingua:
GER
Soggetto:
PREDICTORS; TRIALS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
20
Recensione:
Indirizzi per estratti:
Indirizzo: Kugler, C Klinikum Kassel, IVM Inst Integrat Versorgung Med, Monchebergstr41-43, D-34125 Kassel, Germany Klinikum Kassel Monchebergstr 41-43 KasselGermany D-34125 many
Citazione:
C. Kugler et al., "Australian refined diagnosis related groups: problems of grouping and application in stroke care", DEUT MED WO, 125(51-52), 2000, pp. 1554-1559

Abstract

Background and objectives: With the Health Reform 2000, the Australian Refined Diagnosis Related Groups (AR-DRG), Version 4.1 have been chosen as thebasis for the future German costing system for hospitals. With regard to Stroke Severity (Barthel Index [BI]) we investigated to what extent the grouping according to AR-DRGs can reproduce healthcare expenditures for such patients. Options to adapt and optimize the system are discussed. Patients and Methods: 632 patients who had suffered a cerebrovascular accident and were discharged from conservative acute care in 1999, were classified according to the AR-DRGs. For the grouping we alternatively used data from the current hospital information system and a stroke database for quality assurance. The results were also compared with the clinical profiles forthe public hospital sector of the corresponding DRGs in Australia (1997-98). Results: On average 0.99 additional diagnoses per case were documented in the hospital information system, compared to 3.65 in the stroke database. In the stroke database 177 cases (36.8%) were assigned to the DRC with the highest cost weight. 53.7% of these patients suffered a serious stroke (BI <30). Grouping on the basis of hospital information system data led only to14 cases (2.8%) assigned to the DRG with the highest cost weight. Conclusions: Type and extent of additional diagnoses are crucial for the grouping process. From a clinical and economic point of view, measures of disability and impairment should be assigned to the grouping process to improve homogeneity under both aspects. Scores can also serve for determining reliable outcome parameters. For the development of an outcome related reimbursement system, procedures must be included in the definition of medical DRGs. In future, DRGs, which cover overlapping healthcare sectors, should be developed for patients with poststroke rehabilitation.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 01/12/20 alle ore 16:45:17