Diagnosis Related Groups: Product Line Management within Hospitals

Fetter, Robert B.; Freeman, Jean L.

doi:10.5465/amr.1986.4282622

Cited by 148 publications

(42 citation statements)

References 3 publications

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“…The costs for healthcare visits and delivery costs were calculated following NordDRG (Nordic Diagnosis Related Groups) outlines , using DRG tariffs for 2014 in the South‐Eastern Health Care Region in Sweden. Delivery costs were counted individually for every participant assigned by a “DRG‐grouper” program, based on diagnoses classified by the International Classification of Diseases, 10th revision and procedures classified by the Nomesco Classification of Surgical Procedures, taking into account the presence of complications or comorbidities and the age of the patient.…”

Section: Methodsmentioning

confidence: 99%

Severe fear of childbirth indicates high perinatal costs for Swedish women giving birth to their first child

Nieminen

Wijma

Johansson

et al. 2017

Acta Obstet Gynecol Scand

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Section: Methodsmentioning

confidence: 99%

Severe fear of childbirth indicates high perinatal costs for Swedish women giving birth to their first child

Nieminen

Wijma

Johansson

et al. 2017

Acta Obstet Gynecol Scand

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“…Et system hvor man, ligesom i industriel produktion, havde et forhåndskendskab til omkostningerne for hver enkelt produceret vare, og således prospektivt kunne afsaette resurser til vareproduktionen -i dette tilfaelde resurser til behandlingen af patienter. Inspirationen fra industriel produktion gav anledning til en grundlaeggende gentaenkning af hospitalsvirksomhed som bestående af en raekke produktionslinjer hver karakteriseret ved de diagnoser, der blev behandlet heri samt de resurser, der gik til behandling (Fetter & Freeman, 1986 Det skete gennem kortlaegning af hvilke parametre, der påvirkede omkostningen af specifikke diagnosers behandling med det videre formål at udvikle et system, som gjorde det muligt at inddele behandlede patienter i specifikke grupper, indenfor hvilke behandlingsomkostninger kunne antages at vaere nogenlunde ens.…”

Section: Udviklingen Af Drg: Diagnosen Som Styringsmaessigt Interventunclassified

Diagnoser som styringshybrider Diagnoserelaterede grupper i sundhedsvæsenet

Bossen¹,

Danholt²,

Klausen³

2016

TFSS

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Denne artikel viser, hvordan diagnoser indgår som centrale komponenter i en styrings-infrastruktur på sundhedsområdet. Herved opnås en forståelse af diagnoser som ’styrings-hybrider’, som på en og samme tid betegner patienters lidelser og deres regnskabsmæssige værdi i systemer af Diagnose-Relaterede Grupper (DRG). DRG er et internationalt udbredt system til at knytte patienter og deres behandlingsomkostninger sammen i faste kategorier med henblik på at måle hospitalers produktivitet. Med afsæt i Science-Technology-Studies (STS)-feltet analyserer artiklen, hvorledes diagnoser overskrider deres kliniske funktioner, og transformeres til DRG i en styrings-infrastruktur, der forbinder stat, regioner og hospitalsafdelinger. Formålet er at bidrage til en forståelse af diagnosers rolle som infrastrukturerende og således som både dele af en infrastruktur og som performative elementer med væsentlige samfundsmæssige betydninger og funktioner. Artiklen præsenterer analyser af (i) hvorledes diagnoser spiller en central rolle i et historisk skifte i magtforholdet mellem lægefaglige og stat, (ii) hvordan behandlingen af diagnoser med DRG bliver et administrativt anliggende, der kræver nye særskilte kompetencer og funktioner, (iii) hvordan diagnoser som grundkomponenter i DRG muliggør finansieringsmodeller og forfølgelsen af en række styringsmæssige mål, som førhen ikke var mulige, og (iiii) hvordan DRG-systemet har afstedkommet kritik af dets effekter som incitamentssystem. Endeligt reflekterer artiklen over, hvordan DRG-systemet alternativt kan anskues som en samfundsudviklende infrastruktur, idet det forsamler og skaber gensidigt involverende interaktioner imellem politiske, administrative og sundhedsprofessionelle domæner. En sådan indsigt bidrager til en udvidet forståelse af infrastrukturers roller som aktører snarere end blot redskaber i samfundet.Diagnoses as governance hybrids: Diagnosis related groups in healthcareThis paper analyses how diagnoses comprise a central component in the governance infrastructure of health care. A view upon diagnoses as ‘governance hybrids’ enables a perspective that sees diagnoses simultaneously as designating patients’ diseases and their accountable value in the system of Diagnosis Related Groups (DRG). DRG is an internationally widespread system that categorises patients into groups that are clinically meaningful and have approximately the same average costs. Based on Science-Technology-Society studies (STS), the paper analyses how diagnoses transgress their clinical functions and are transformed into DRG in a governance infrastructure that connects the state, regions and hospital departments. The aim is to contribute to an understanding of diagnoses as infrastructuring and hence as both parts of an infrastructure and as performative elements with societal consequences. The paper presents analyses of (i) how diagnoses play a central role in a historical change in the power relations between clinicians and the state, (ii) how processing of diagnoses through DRG becomes an administrative matter requiring new special competences and functions, (iii) how diagnoses as part of DRG enables financial modeling and pursuance of governance goals that were not previously possible, and finally (iv) how the DRG system has spurred criticism due to its perceived effects as an incentive system. Lastly, the paper reflects upon how the DRG system can be regarded as an infrastructure that develops and constitutes society, because it gathers and creates mutually involving interactions between political, administrative and healthcare professional domains. Thus infrastructures such as DRG are not only tools, but also societal actors.

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“…In this context, Diagnosis-Related Group (DRG), as an empirical classification of the final products in a hospital (Fetter and Freeman, 1986), represents a topic of concern for research and a critical success factor for healthcare systems worldwide. In fact, most of the developed countries have already introduced DRG-systems (Busse et al, 2011) for driving resources allocation.…”

Section: Introductionmentioning

confidence: 99%

“…Despite DRGs classify patient groups with similar expected patterns of resource use depending on their diagnosis and treatments (Fetter and Freeman, 1986), it is not still clear the association between DRGs and related care processes (Mans et al, 2009). Therefore, managers are not able to relate the resources received (and theoretically consumed) with the process flow.…”

Section: Introductionmentioning

confidence: 99%

Linking Diagnostic-Related Groups (DRGs) to their Processes by Process Mining

Stefanini

Aloini

Dulmin

et al. 2016

Proceedings of the 9th International Joint Conference on Biomedical Engineering Systems and Technologies

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The knowledge of patient-flow is very important for healthcare organizations, because strongly connected to effectiveness and efficiency of resource allocation. Unfortunately, traditional approaches to process analysis are scarcely effective and low efficient: they are very time-consuming and they may not provide an accurate picture of healthcare processes. Process mining techniques help to overcome these problems. This paper proposes a methodology for building a DRG related patient-flow using process mining. Findings show that it is possible to discover the different sequences of activities associated with a DRG related process. Managerial implications concern both process identification, analysis and improvement. A case study, based on a real open data set, is reported

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Diagnosis Related Groups: Product Line Management within Hospitals

Cited by 148 publications

References 3 publications

Severe fear of childbirth indicates high perinatal costs for Swedish women giving birth to their first child

Severe fear of childbirth indicates high perinatal costs for Swedish women giving birth to their first child

Diagnoser som styringshybrider Diagnoserelaterede grupper i sundhedsvæsenet

Linking Diagnostic-Related Groups (DRGs) to their Processes by Process Mining

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