title: [DRG/ROD: limits to their application in nephrology].
abstract: The ministerial decrees of 15/4/94 and 14/12/94 defined the new payment schedules for hospital services during ordinary and day hospitalization; the hospital discharge form (SDO) is the main source of this information. The services are defined by the classification of ROD ("raggruppamenti omogenei di diagnosi"), adapted from the American DRG ("Diagnosis related groups"), which have substituted the traditional system of payment by production factor. On the basis of the DRG identified and the length of hospital stay, the Region pays the hospital the cost of hospitalization. The main diagnosis at discharge, secondary diagnosis, complications and diagnostic/therapeutic procedures all contribute to the determination of 489 DRG. Groups of pathologies are reclassified into 25 MDC ("Major Diagnostic Categories"). The 11th MDC includes the uronephrological DRG (302-333). The nephrological sector has been penalized by the inadequate value given to related procedures and diagnostic limitations. In order to guarantee efficacious diagnostic and therapeutic procedures, without impoverishing the nephrological budget and reducing the management autonomy of the divisions and autonomous services with hospitalization, it is necessary to introduce quality controls and corrective measures to the procedures that maintain the value of diagnosis and comply with financial considerations.
authors.affiliation: Direzione Sanitaria, UO Nefrologia e Dialisi, ASR USL n. 11, Vercelli.
authors.forename: P
authors.initials: P
authors.lastname: Colombo
authors.forename: M C
authors.initials: MC
authors.lastname: Bona
authors.forename: C
authors.initials: C
authors.lastname: Peona
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002017:Budgets; D002648:Child; D003953:Diagnosis-Related Groups; D003955:Diagnostic Tests, Routine / Q000191:economics; D006077:Government Agencies / Q000191:economics; D017721:Hospital Costs; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D007558:Italy; D007674:Kidney Diseases / Q000175:diagnosis / Q000191:economics* / Q000628:therapy; D008875:Middle Aged; D012051:Reimbursement Mechanisms; D013222:State Medicine / Q000191:economics* / Q000331:legislation & jurisprudence
vernacular_title: DRG/ROD: limiti di applicazione in nefrologia.