Improving the homogeneity of diagnosis-related groups (DRGs) by using clinical laboratory, demographic, and discharge data.
For 48 of the most common diagnosis-related groups (DRGs) at our hospital, we examined the ability of clinical laboratory tests, demographic data, and ICD-9-CM codes, which provide a measure of severity of illness, to predict patients' length of stay (LOS) more accurately than DRGs alone. For 10 of 20 medical DRGs and 13 of 23 surgical DRGs examined, we were able to increase the ability to predict LOS by at least 10 per cent. The laboratory tests that proved most predictive of LOS over all DRGs were the mean serum sodium, potassium, bicarbonate, and albumin. The system is data driven, objective, and flexible, thus ensuring its utility for the purpose of equitable reimbursement.
Goldman
E S
ES
Department of Laboratory Medicine, School of Medicine, University of California, San Francisco 94143-0626.
Easterling
M J
MJ
Sheiner
L B
LB
D002140:California; D002245:Carbon Dioxide / Q000097:blood; D003710:Demography; D003953:Diagnosis-Related Groups / Q000379:methods*; D006801:Humans; D007902:Length of Stay; D011188:Potassium / Q000097:blood; D012044:Regression Analysis; D012709:Serum Albumin / Q000032:analysis; D012720:Severity of Illness Index; D012964:Sodium / Q000097:blood
D012709:Serum Albumin; D002245:Carbon Dioxide; D012964:Sodium; D011188:Potassium