title: Distinguishing between tertiary and secondary facilities: a case study of cardiac diagnostic-related groups (DRGs).
abstract: OBJECTIVE
  To develop a classification of tertiary cardiac DRGs in order to investigate differences in tertiary/secondary product mix across New Zealand district health boards (DHBs).
  
  
  METHODS
  67 DRGs from 85,442 cardiac cases were analysed using cost weights and patient comorbidity complexity levels, which were used as a proxy for complexity.
  
  
  RESULTS
  The research found high variability of severity within some DRGs. 5 DHBs are the main providers of 27 DRGs which are high cost and identified as tertiary by several ADHB clinicians; the same 5 DHBs have on average higher severity by DRG than the other DHBs.
  
  
  CONCLUSIONS
  NZ tertiary hospitals have a product mix of DRGs with higher complexity than secondary hospitals. Funding based on case weights needs to recognise the additional resource requirements for this higher complexity.
authors.affiliation: Department of Accounting and Finance, The University of Auckland, New Zealand. p.rouse@auckland.ac.nz
authors.forename: Paul
authors.initials: P
authors.lastname: Rouse
authors.forename: Ajit
authors.initials: A
authors.lastname: Arulambalam
authors.forename: Ralph
authors.initials: R
authors.lastname: Correa
authors.forename: Cornelia
authors.initials: C
authors.lastname: Ullman
mesh_terms: D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000453:epidemiology; D003953:Diagnosis-Related Groups / Q000145:classification*; D006761:Hospitals / Q000145:classification*; D006801:Humans; D009017:Morbidity / Q000639:trends; D009520:New Zealand / Q000453:epidemiology; D012720:Severity of Illness Index