Diagnosis-Related Group Refinement with Diagnosis- and Procedure-Specific Comorbidities and Complications

Freeman, Jean L.; Fetter, Robert B.; Park, Ha Young; Schneider, Karen; Lichtenstein, Jeffery L.; Hughes, John S.; Bauman, William; Duncan, Charles C.; Freeman, Daniel; Palmer, George R.

doi:10.1097/00005650-199508000-00006

Cited by 52 publications

(26 citation statements)

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“…Similar to findings in our prior work regarding uncomplicated ARF and hospital resource utilization, the RDRG severity of illness classes (low, moderate, high) maintain a strong graduated association with the receipt of post-hospital care in uncomplicated ARF patients [11]. This investigation is the first to demonstrate the utility of this risk-adjustment model in forecasting post-hospital resource use for an acute illness [19, 20]. …”

Section: Discussionsupporting

confidence: 77%

“…Lastly, disease variables included both dialysis and severity of illness. Dialysis was defined by the presence of either of the following ICD-9-DM procedure codes 39.95 or 54.98, while the severity of illness (e.g., low, moderate, high) was defined using the refined DRG (RDRG) method, which employs an algorithm based on secondary diagnostic codes and procedures [19, 20]. …”

Section: Methodsmentioning

confidence: 99%

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Uncomplicated Acute Renal Failure and Post-Hospital Care: A Not So Uncomplicated Illness

2008

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Background: Although uncomplicated acute renal failure (ARF) is associated with significant hospital resource utilization, its health care requirements following hospital discharge are not well understood. The goal of this study was to characterize the post-hospital care requirements incurred by patients with uncomplicated ARF and to determine its important influencing factors. Methods: We obtained hospital case mix data sets for a 2-year period (1999–2000) from the Massachusetts Division of Health Care Finance and Policy. Utilizing DRG and ICD-9-CM codes from 23 Massachusetts hospitals, we identified 2,128 adult patients whose primary reason for hospitalization was uncomplicated ARF. Post-hospital care was defined as the receipt of extended facility care or home health care following hospital discharge. Results: Nearly 50% of patients hospitalized with uncomplicated ARF required some type of post-hospital care, of whom 27% underwent extended facility care while 22% received home health care. The post-hospital care requirements for uncomplicated ARF were similar to those for serious medical conditions (e.g. heart failure) and exceeded those of many common illnesses (e.g., bronchitis). Advancing age, worsening severity of illness, female gender, and emergency room admission were independently associated with receipt of post-hospital care (p < 0.05). A trend existed between less frequent post-hospital care requirements and hospitalization at academic medical centers compared with non-academic hospitals. Conclusions: Uncomplicated ARF is frequently associated with prolonged care following hospitalization. As the health care utilization for ARF becomes better characterized, these post-hospital care resources should not be overlooked.

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Section: Discussionsupporting

confidence: 77%

Section: Methodsmentioning

confidence: 99%

Uncomplicated Acute Renal Failure and Post-Hospital Care: A Not So Uncomplicated Illness

2008

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“…Premier's database contains an APR DRG for each patient, as well as an APR DRG severity score. The APR DRGs distinguish among patients using disease-or procedure-specific classes of secondary diagnoses [13]. The APR DRG severity score is a prediction of resource utilization based on discharge abstracts that assigns patients to four levels: 1 = minor, 2 = moderate, 3 = major, and 4 = extreme.…”

Section: Definitions and Variables Assessedmentioning

confidence: 99%

Selection of Prophylactic Antimicrobial Agent May Affect Incidence of Infection in Small Bowel and Colorectal Surgery

Eagye

Nicolau²

2011

Surgical Infections

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“…2 This shift has caught many pediatric hospitals off guard, as little data exist to guide the development of prospective payment rates for pediatric diagnoses, [6][7][8][9] although there is some evidence of improved accuracy in refinements of the DRG classification system for children. 10,11 Our study explores 2 fundamental issues confronting pediatric tertiary care centers that enter competitive prospective contracts for common pediatric procedures or conditions: (1) how does the presence of patient chronic disease influ-ence resource utilization and length of stay (LOS) for common pediatric conditions? and (2) if children's hospitals (defined as either children's hospitals or academic pediatric tertiary care centers) provide care for common pediatric conditions, but treat a disproportionate number of these common conditions in complicated patients with 1 or more chronic diseases, what effect will this have on their financial solvency, when health care is financed prospectively in a competitive market?…”

mentioning

confidence: 99%

The Influence of Chronic Disease on Resource Utilization in Common Acute Pediatric Conditions

Silber

Gleeson²,

Zhao³

1999

Arch Pediatr Adolesc Med

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Diagnosis-Related Group Refinement with Diagnosis- and Procedure-Specific Comorbidities and Complications

Cited by 52 publications

References 0 publications

Uncomplicated Acute Renal Failure and Post-Hospital Care: A Not So Uncomplicated Illness

Uncomplicated Acute Renal Failure and Post-Hospital Care: A Not So Uncomplicated Illness

Selection of Prophylactic Antimicrobial Agent May Affect Incidence of Infection in Small Bowel and Colorectal Surgery

The Influence of Chronic Disease on Resource Utilization in Common Acute Pediatric Conditions

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