| Theme | Application of Clinical Path for Dialysis Treatment | |
|---|---|---|
| Title | Is DRG applicable as casemix complexity in patients with kidney disease? | |
| Publish Date | 2001/05 | |
| Author | Koichi Kawabuchi | Graduate School, Tokyo Medical and Dental University |
| [ Summary ] | The development of casemix complexity has been conducted to explain the variations of hospital costs. DRG (Diagnosis Related Group) is one of the casemix complexity. However, there are several alternative DRG systems such as HCFA-DRG, AP-DRG (All patient DRG), APR-DRG (All-Patient Refined DRG), and also the Japanese DRG (J-DRG) developed by Ministry of Health and Welfare in order to conduct the pilot study on DRG/PPS (Prospective Payment System). The question is whether these DRGs are applicable as casemix complexity of patients with kidney disease. In our research, while using the patients discharge database which contains 281, 218 cases collected from 42 hospitals, we have computed the reduction of variance (R2) on length of stay. As far as MDC11 (Major Diagnostic Category 11) is concerned, we have found that J-DRG is unexpectedly one of the most suitable among alternative DRG. However, we need further refinement of DRG since its R2 is only 0.2179 and relatively low. |
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