title: [Differentiation of coding quality in orthopaedics by special, illustration-oriented case group analysis in the G-DRG System 2005].
abstract: OBJECTIVE
  We introduce a grouping system for clinical practice which allows the separation of DRG coding in specific orthopaedic groups based on anatomic regions, operative procedures, therapeutic interventions and morbidity equivalent diagnosis groups. With this, a differentiated aim-oriented analysis of illustrated internal DRG data becomes possible.
  
  
  METHODS
  The group-specific difference of the coding quality between the DRG groups following primary coding by the orthopaedic surgeon and final coding by the medical controlling is analysed. In a consecutive series of 1600 patients parallel documentation and group-specific comparison of the relevant DRG parameters were carried out in every case after primary and final coding.
  
  
  RESULTS
  Analysing the group-specific share in the additional CaseMix coding, the group "spine surgery" dominated, closely followed by the groups "arthroplasty" and "surgery due to infection, tumours, diabetes". Altogether, additional cost-weight-relevant coding was necessary most frequently in the latter group (84%), followed by group "spine surgery" (65%). In DRGs representing conservative orthopaedic treatment documented procedures had nearly no influence on the cost weight.
  
  
  CONCLUSIONS
  The introduced system of case group analysis in internal DRG documentation can lead to the detection of specific problems in primary coding and cost-weight relevant changes of the case mix. As an instrument for internal process control in the orthopaedic field, it can serve as a communicative interface between an economically oriented classification of the hospital performance and a specific problem solution of the medical staff involved in the department management.
authors.affiliation: Orthopädische Universitätsklinik Ulm am RKU. uwe.schuetz@uniklinik-ulm.de
authors.forename: U
authors.initials: U
authors.lastname: Schütz
authors.forename: H
authors.initials: H
authors.lastname: Reichel
authors.forename: K
authors.initials: K
authors.lastname: Dreinhöfer
mesh_terms: D000046:Academic Medical Centers / Q000191:economics* / Q000706:statistics & numerical data*; D003953:Diagnosis-Related Groups / Q000191:economics* / Q000458:organization & administration*; D005858:Germany; D005102:Health Expenditures / Q000706:statistics & numerical data; D019637:Orthopedic Procedures / Q000191:economics* / Q000706:statistics & numerical data*; D011785:Quality Assurance, Health Care; D040841:Resource Allocation / Q000191:economics / Q000706:statistics & numerical data