PubMed Health⌕ Search
Home/Archive/PubMed

PubMed · 3113521

Diagnostic related groups: problems and opportunities.

P Van Etten
View original source ↗Export metadata ↓

Abstract

Diagnostic Related Groups (DRGs) represent a paradox. On the one hand, they lack clinical meaningfulness, particularly in regard to cancer patients. DRG 403, which includes patients diagnosed than 69 and/or complications or comorbidities, is particularly inadequate as a tool to group together homogeneous patients. On the other hand, the practice of classifying similar patients into clinically meaningful groups represents a potentially valuable new tool for providing cost-effective patient care.

Explore related subjects

Diagnosis-Related GroupsHumansJournal Article

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

P Van Etten. 1987. Diagnostic related groups: problems and opportunities.. https://pubmed.ncbi.nlm.nih.gov/3113521/

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

PubMed2006

Reliability of diagnoses coding with ICD-10.

OBJECTIVE: Reliability of diagnoses coding is essential for the use of routine data in a national health care system. The present investigation compares reliability of diagnoses coding with ICD-10 between three groups of coding subjects. METHOD: One hundred and eighteen students coded 15 diagnoses lists, 27 medical managers from hospitals 34 discharge letters, and 13 coding specialists 12 discharge letters. Agreement in principal diagnosis was assessed using Cohen's Kappa and the fraction of coincidences over the number of pairs, agreement for the full set of diagnoses with a previously developed measure p(om). RESULTS: Kappa values were fair (managers) or moderate (coders) for terminal codes with 0.27 and 0.42 (agreement 29.2% versus 46.8%), substantial for the chapter level with 0.71 and 0.72 (agreement 78.3% versus 80.8%). p(om) was lower for the full set of diagnoses than for principal diagnoses, for example in case of managers with 0.21 versus 0.29 for terminal codes. Best results were achieved by students coding diagnoses lists. In summary, the results are remarkably lower than in earlier publications. CONCLUSION: The refinement of the ICD-10 accompanied by innumerous coding rules has established a complex environment that leads to significant uncertainties even for experts. Use of coded data for quality management, health care financing, and health care policy requires a remarkable simplification of ICD-10 to receive a valid image of health care reality.

Diagnosis-Related Groups↗