Linking nursing care to medical diagnoses: heterogeneity of patient groups.
OBJECTIVE
The new budget system for Dutch hospitals makes use of patient groups that are highly homogeneous in terms of diagnosis and treatment combinations (diagnose behandeling combinaties (DBC)). These DBCs are the Dutch DRG variants. The DBC mainly concerns medical care; nursing care is almost regarded as a constant factor. In this study the DBC is linked to the nursing minimum data set for The Netherlands (NMDSN), to explore the degree of homogeneity in terms of nursing care for patient groups that are homogeneous in terms of the DBC.


METHODS
In nine Dutch hospitals, patient information was collected by means of the NMDSN. To answer the question, we performed a secondary data analysis on the NMDSN. First, groups were formed in terms of medical diagnoses as defined in the DBC. Next, explorative statistical analyses were used to form homogeneous groups in terms of nursing diagnoses. These groups were compared in terms of the nursing care interventions and in terms of medical diagnoses.


RESULTS
Some medical diagnoses seem to be homogeneous, others more heterogeneous in terms of nursing care.


CONCLUSIONS
Limitations in the study design hinder a firm conclusion. However, the results discourage the use of the medical DBC for nursing care.
van Beek
Lisanne
L
Acquest Research and Development Dorpsstraat 50, 2396 HC Koudekerk aan den Rijn, The Netherlands. acquest@acquest.nl
Goossen
William T F
WT
van der Kloot
Willem A
WA
D003933:Diagnosis; D003953:Diagnosis-Related Groups / Q000706:statistics & numerical data*; D006801:Humans; D009426:Netherlands / Q000453:epidemiology; D009732:Nursing Care / Q000706:statistics & numerical data*; D009733:Nursing Diagnosis / Q000706:statistics & numerical data*; D048108:Nursing Informatics / Q000706:statistics & numerical data*; D011785:Quality Assurance, Health Care / Q000379:methods*; D013223:Statistics as Topic