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Diagnosis related groups --- Hospital patients --- Evaluation --- Classification
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Hospital utilization --- Diagnosis related groups --- United States.
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The authors reabstracted a nationally representative sample of 7,887 Medicare charts to determine how much of the change in Medicare's Case Mix Index between 1986 and 1987 was due to upcoding or DRG (diagnosis-related group) creep. About two-thirds of the actual change is true. Most of the remaining third is attributable to a general change in the completeness of coding; some is attributable to changes in the Grouper program that assigns DRGs to cases using diagnostic and procedural information. Thus, most of the additional $1 billion that Medicare paid to hospitals because of the change in the Case Mix Index appears justified by the additional complexity of the cases of the patients being hospitalized.
Diagnosis related groups --- Hospital patients --- Classification.
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Diagnosis-Related Groups --- Economics, Hospital --- Belgium.
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Endlich schwarz auf weiß: Wie sich Patientenpfade passgenau erstellen, einführen, kalkulieren und managen lassen. Seit 2003 wird es ernst für deutsche Klinken: die Finanzen werden auf Fallpauschalen umgestellt. Damit muss sich auch das Rechnungswesen komplett wandeln! Neues zentrales Steuer- und Kalulationselement sind nun die Patientenpfade. Wie werden diese Pfade etabliert, wie werden sie in der Praxis genutzt? Wie wird die Kostenrechnung darauf aufgesetzt, welche Kostensätze braucht man? Wie lassen sich die Ergebnisse als Qualitäts- und Führungsinstrument nutzen? Die in diesem Buch gesammelten Praxistipps und Erfahrungen der Aarauer Pioniere helfen, die ersten Pfad-Schritte schnell und sicher zu gehen. Im Anhang anschauliche Musterpfade.
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When Congress designed and implemented the prospective payment system (PPS), the best available method to adjust for differences in case mix was the diagnosis-related groups (DRGs). The DRG system classified all patient cases, and had already been implemented in New Jersey's prospective payment system. While some of the problems in an earlier version of the DRGs have been resolved, concern remains that DRGs may need to be refined or replaced to better reflect variation in patient condition. This report was prepared as background to a report that the Congress requested from the Health Care Financing Administration. It compares the structure and performance characteristics of case mix adjustment measures being considered as replacements for or refinements to the diagnosis-related groups. The authors reviewed published papers, prepublication drafts, and technical reports on five case mix systems: APACHE II, Disease Staging, MEDISGRPS, Patient Management Categories, and Severity of Illness Index. The alternative systems differ in classification structure, data requirements, and stage of development. The findings suggest that, at present, no system appears to perform better than the DRGs.
Hospitals --- Hospital patients --- Diagnosis related groups --- Prospective payment. --- Classification --- Evaluation.
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Diagnosis related groups --- Medicare --- Health insurance claims --- Claims administration --- Standards.
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Diagnosis related groups --- Medicare --- Health insurance claims --- Claims administration --- Standards.
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