DRG

1

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2
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3
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4
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5
(No Transcript)
6
???? ????? ?? ???? ?"? DRG

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7
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8
???????...

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Throwing Money Away (1)

• A 26 year old patient admitted for treatment of a
  compound fracture of the radius and ulna, upper
  proximal epiphysis. Fracture treated by an open
  wound reduction with internal fixation.
• The responsible doctor records the diagnosis and
  treatment as
• Fracture of Arm Reduction
• Because of the lack of detail the episode would
  be coded with
• T100 poorly defined fracture of upper limb,
  elbow, forearm
• 4736300 Closed reduction of fracture without
  internal fixation, arm, NOS
• The resulting AR-DRG assignment is
• DRG I75
• Average length of stay 1.8400 days
• Income per patient Cost weight 0.5300 x
  Benchmark price (say A1,500.00)
• A795.00

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Throwing Money Away (2)

• Recording the diagnosis and procedure accurately
  will result in .
• S528 Fracture, radius with ulna, upper end (any
  part)
• 9054101 Open reduction, separated epiphysis,
  radius and ulna
• The resulting AR-DRG assignment is
• DRG I19Z
• Average length of stay 2.7700 days
• Income per patient Cost weight 1.1700 x
  Benchmark price (say A1,500.00)
• A1,755.00
• An income INCREASE of 950.

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Throwing Money Away (3)

• Example 2
• The effect of not coding or not correctly coding
  the surgical procedure(s).
• Bad coding lost income

12
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• ????? ?????? ?????? ?-DRG GROUPER ???? ????
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13
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• ????? ?-GROUPER ???????? ?? ????? ??????? ?????
  ???? ?????? 2001 ???? ???????? ????? ??????
• ????? ????? ????? ?"? ????? ?-DRGs
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15
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(No Transcript)
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Surgical Procedures
Correlation
0.79 between Australia weights and Israeli costs
weights (p-value lt 10-4) 0.77 between Australia
weights and Israeli collection weights (p-value lt
10-4 )
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Internal medicine diagnosis
Correlation 0.51 between Australia weights and
Israeli costs weights p-value 0.05
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Correlation 0.63 p-value 0.011
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?????? ???-???????? ?????? ?????? TMR

• ????? ???????? ?? 350 ??????/?????? ??????? ?????
  (????? ????? TMR) ?? ??? 10,000 ???????? ????
  2003.
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  ????? ????? ???????? ?? ???? ????? ????????
  ??????? ?????? ????????
• ???????? ??? ????? ????? ????? ?????? ?????
  ???????? ??? 0.61

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22
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  ????? ????? ?????? ????? DRG ?????? ????? ?????
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