Nursing diagnosis, DRGs, and length of stay

Halloran, Edward J.; Kiley, Mary-Lou; England, Margaret

doi:10.1016/s0897-1897(88)80041-7

Cited by 9 publications

(12 citation statements)

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“…In 2011, the General Office of the State Council of China issued “Notice on the work arrangement for the pilot reform of public hospitals”: explore reforms of a variety of basic medical insurance payment methods and vigorously promote a variety of payment methods such as capitation payment, DRG‐based prospective payment, and the total amount of prepaid. Based on introduction of all patients diagnosis related groups (AP‐DRGs) in the United States and Australia refined DRGs (AR‐DRGs), BJ‐DRGs has been developed into 650 DRG groups for nearly 8 years; since October 2011, Beijing has had six of top tertiary hospitals participating in BJ‐DRGs‐based payment pilot implementation, pilot DRGs has 108 groups, six hospitals all have about 5% of profits, similar to Medicare inpatient's results and no loss in one hospital, but in pilot DRG groups, some set profit and some heavy loss. Certain top tertiary hospital in Beijing is one of the pilot hospitals; in order to analyze the profit and loss situation in the pilot BJ‐DRGs‐based payment, explore the reasons of profit and loss of DRG groups, in this article, we analyzed the results of 47 148 cases of pilot BJ‐DRGs payment from December 2011 to July 2018 in the hospital and assess the effects of BJ‐DRGs‐based payment on the pilot hospital.…”

Section: Introductionmentioning

confidence: 83%

The pilot results of 47 148 cases of BJ‐DRGs‐based payment in China

Zeng

2019

Health Planning & Management

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Summary Purpose Diagnosis‐related groups (DRGs)‐based payment is an important tool for containment of inpatient expenditure rise in many countries. As a major developing country, China has introduced DRGs in the health reform. Beijing, the capital of China, developed a local DRGs version (BJ‐DRGs) whose performance needs to be evaluated before universal utilization. The objective of this study was to survey the effect of BJ‐DRGs‐based payment on a pilot hospital. Methods We surveyed the profit and loss situation of 47 148 cases of hospital discharged patients in 107 groups of pilot BJ‐DRGs‐based payment from December 2011 to July 2018 in certain top tertiary hospital in Beijing. Results In pilot 107 groups of DRGs, there were 77 groups (71.96%) in profit and 30 groups (28.04%) in loss; average length of inpatient stay was 7.47 days, average inpatient expenditure ¥17 821.19, average DRGs standard unit price ¥15 896.83, average self‐pay expenditure ¥1 117.04, and average profit ¥1 849.65; logistic regression showed that whether the pilot hospital of BJ‐DRGs‐based payment was in profit or loss was correlated negatively with inpatient expenditure, length of inpatient stay, drug expenditure, expenditure of medical consumables, and pilot years, and positively with DRGs standard unit price, self‐pay expenditure, and age and gender (P < .0001). Conclusion BJ‐DRGs‐based payment is the first implemented DRGs‐based prospective payment system in China. The current DRGs pilot model made the pilot hospital appear profitable as a whole and its length of inpatient stay decline.

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Section: Introductionmentioning

confidence: 83%

The pilot results of 47 148 cases of BJ‐DRGs‐based payment in China

Zeng

2019

Health Planning & Management

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“…My own quantitative research addressed both the time spent by nurses with patients and the time patients spent in hospital (Halloran et al. 1988).…”

Section: Human Needs Versus Disease Classesmentioning

confidence: 99%

Women hold up half the sky

Halloran¹

2009

International Nursing Review

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The English word nurse is used synonymously with the word woman. Most nurses are women and where pronouns are used in the singular, the nurse is invariably referred to as she. This may seem natural to many of you but to me it does not. I am from a very unique situation in both time and place. Ours was a time of enormous privilege for men. Education, pay, position and opportunity were all disproportionately given to men, even when the work was performed by women. Hospitals, the locus of health care in America, were and are dominated by elite men. After 35 years of study of patients, their nurses, and the agencies we work for -I have come to believe that men have failed us. Women offer us all hope for a better future. For centuries women of the world have been denied substantive education, except for nurses. The education has been meager and reluctantly given, but nonetheless, it places nurses in a unique position. If women are to lead, nurses, by reason of their education, must lead women.

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“…Halloran and Kiley (1987) developed a patient classification system to measure patients' dependency on nursing care during their hospitalization using the quantity of nursing diagnoses. In this study, the patient classification system was significantly associated with hospital length of stay (LOS) and more reliably predicted hospital LOS than the Diagnostic Related Group (DRG) relative cost weight ( Halloran & Kiley, 1987;Halloran et al, 1988). Using nursing diagnoses as a Nursing Severity Index, Rosenthal and colleagues (1992) found that the number of nursing diagnoses at admission was significantly related to hospital mortality.…”

Section: Nanda -International (Nanad -I)mentioning

confidence: 91%

“…Several studies have confirmed that nursing diagnoses are significant predictors of patient outcomes (Halloran & Kiley, 1987;Halloran, Kiley, & England, 1988;Rosenthal et al, 1992;Rosenthal, Halloran, Kiley, & Landefeld, 1995;Welton & Halloran, 1999;Welton & Halloran, 2005). These studies showed that the set of nursing diagnoses selected by nurses can represent the complexity of nursing care provided to patients.…”

Section: Nanda -International (Nanad -I)mentioning

confidence: 93%

“…This finding supports previous studies that nursing diagnoses could be a predictor for poor patient outcomes. A few studies showed that the nursing diagnoses were associated with poor patient outcomes resulting in higher total hospital charges, longer ICU length of stay, and higher in-hospital mortality (Halloran et al, 1988;Rosenthal et al, 1995;Welton & Halloran, 2005). In particular, colleagues (1992, 1995) have used the number of 34 specific nursing diagnoses as a Nursing Severity Index.…”

Section: Noc Outcomesmentioning

confidence: 99%

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Relationship of nursing diagnoses, nursing outcomes, and nursing interventions for patient care in intensive care units

Moon¹

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The purpose of the study was to identify NANDA-I diagnoses, NOC outcomes, and NIC interventions used in nursing care plans for ICU patient care and determine the factors which influenced the change of the NOC outcome scores. This study was a retrospective and descriptive study using clinical data extracted from the electronic patient records of a large acute care hospital in the Midwest. Frequency analysis, oneway ANOVA analysis, and multinomial logistic regression analysis were used to analyze the data. A total of 578 ICU patient records between March 25, 2010 and May 31, 2010 were used for the analysis. Eighty-one NANDA-I diagnoses, 79 NOC outcomes, and 90 NIC interventions were identified in the nursing care plans. Acute Pain-Pain Level-Pain Management was the most frequently used NNN linkage. The examined differences in each ICU provide knowledge about care plan sets that may be useful. When the NIC interventions and NOC outcomes used in the actual ICU nursing care plans were compared with core interventions and outcomes for critical care nursing suggested by experts, the core lists could be expanded. Several factors contributing to the change in the five common NOC outcome scores were identified: the number of NANDA-I diagnoses, ICU length of stay, gender, and ICU type. The results of this study provided valuable information for the knowledge development in ICU patient care. This study also demonstrated the usefulness of NANDA-I, NOC, and NIC used in nursing care plans of the EHR. The study shows that the use of these three terminologies encourages interoperability, and reuse of the data for quality improvement or effectiveness studies. iv TABLE OF CONTENTS LIST OF TABLES vii LIST OF FIGURES ix CHAPTERS I. BACKGROUND AND SIGNIFICANCE

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Nursing diagnosis, DRGs, and length of stay

Cited by 9 publications

References 1 publication

The pilot results of 47 148 cases of BJ‐DRGs‐based payment in China

The pilot results of 47 148 cases of BJ‐DRGs‐based payment in China

Women hold up half the sky

Relationship of nursing diagnoses, nursing outcomes, and nursing interventions for patient care in intensive care units

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