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PubMed · 11187574

Using ICD-10 for case groups.

Abstract

The definition of German case groups now uses an adaptation of the ICD-10: ICD-10-SGBV. For the transformation of the existing ICD-9-based definition into the ICD-10-SGBV an ICD-9/ICD-10 conversion table was used. The derived raw definitions were manually refined in detail. Due to the transformation of the classification system, the number of definitions increased immensely, as the ICD-10 SGBV is by far more detailed than the formerly used ICD-9. In our opinion, ICD-10 SGBV is not ideal for the definition of case groups, because this classification system is designed to support statistics on morbidity and mortality, but definitions of case groups are oriented to cost factors. Therefore the definition of case groups should be based on a specially designed classification system or one should reassess the necessity of a parallel definition by codes of classifications as well as by text. In both alternatives the introduction of a detailed and systematic medical documentation with expressive terminology systems will offer the advantage of classifying patients into medical oriented classifications as well as case groups.

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BibTeXRIS

J Stausberg, A Zaiss, J Fuchs, A Berke. 2000. Using ICD-10 for case groups.. https://pubmed.ncbi.nlm.nih.gov/11187574/

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[Measuring case severity with a DRG-based reimbursement system].

BACKGROUND: The Australian Refined Diagnosis-Related Groups (AR-DRGs) will be the model for the German DRGs (G-DRGs). Their system to measure severity of illness will be a major point of interest. METHOD: The most common systems for measuring severity of illness are presented and compared with the AR-DRGs based on criteria regarding applicability. RESULTS: None of the systems for measuring severity of illness fits all the criteria. They can be used for reimbursement of inpatient care or for quality assurance, but not for both at the same time. The designated areas for the use of the systems should not be exceeded. CONCLUSION: AR-DRGs are very complex in measuring the costs per case (severity of illness in terms of efficiency). They are not able to support quality assessment by risk adjustment (severity of illness in terms of medical complexity). A less complex system would have been easier to transfer to Germany with the same incentives for providing effective care.

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