Patient Classification Systems

Term Paper Title	Patient Classification Systems
# of Words	4272
# of Pages (250 words per page double spaced)	17.09

Patient Classification Systems

|< á
á
>|

ABSTRACT

INTRODUCTION: To compare cost weights of different patient classification systems (PCS) the proportion of
cost weights of pairs of patient groups are calculated in each system. The hypothesis being tested is: The
proportion of cost weights of two case groups (diseases/procedures groups) classified by the same PCS is
equal in all PCSs.

MATERIAL: Case groups of this theoretical study are: Simple hernia procedures, simple appendectomy,
cholecystectomy (for patients < 65 years without complications and without comorbidities). The compared PCS
are HCFA-DRG, AP-DRG, PMC, Disease Staging, HRG, German Case Groups, Austrian Diagnosis Groups
(LDF).

RESULT: This study shows that the cost weight proportions of simple diseases with O.R. procedures vary in
part considerably between the compared patient classification systems.

CONCLUSIONS: It seems to be necessary that cost weights are calculated for each country that is to say
population. And: There have to be descriptions of what is included in a case group as a sort of product
definition (e.g. ways of treatment and quality ranges).

                                                                                                                                                                                                                   |< á
á
>|

INTRODUCTION

Clinical information systems should be able to inform about the hospital production. A way often used to measure the treatment of
patients is the use of cost weights of hospital case groups related to diagnoses and/or procedures from which case mix indices can
be calculated.

In this paper I will present a comparison of cost weights from different patient classification systems. Because there is no common
scale for cost weights (no common point "one") I have calculated proportions of cost weights of pairs of case groups in each PCS.
The aim of this paper is to show if these proportions are the same in different PCSs.

                                                                                                                                                                                                                   |< á
á
>|

METHOD AND MATERIAL

The proportions of cost weights of different case groups should mirror the proportions of costs of the corresponding treatment. More
explicit: If a cholecystectomy produces costs which are one and a half times higher than the costs of a hernia procedure, then the
cost weights are expected to be in a proportion of 1.5 : 1 in each PCS.

For this theoretical study three diseases without comorbidities or complications for patients who are less than 65 years of age were
chosen as test cases:

                                                                                                                                                                                      Table 1: Tested Case Groups

                                                                              Case Group
                                                                                                                                ICD-9-CM/1
                                                                                                                                                            ICD-9-CM/3
                                                        Operation of simple hernia
                                                                                                                                550.90
                                                                                                                                                            53.00
                                                        Simple appendectomy
                                                                                                                                540.9
                                           ...

Read entire document