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Distribution of critically ill patients (CIP) with severe sepsis (SS) according to the major diagnostic categories (MDC) of the diagnosis-related groups (DRG)

  • J Ruiz Moreno
  • E González Marín
  • MJ Esteve Paños
  • M Juliá Amill
  • N Suárez Álvarez
  • M Moral Guiteras
  • F Baigorri González
  • A Artigas Raventós
Open Access
Poster presentation
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Keywords

Public Health Alcohol Severe Sepsis Competitive Advantage Relative Weight 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Introduction

Apart from financial purposes (cost accounting), DRG as case - mix system are not used for obtaining competitive advantage. MDC can be useful to classify the SS; if so, it is possible to assign each focus of sepsis to a specific category, which is important from a socio-economic perspective.

Objectives

  • Identify which MDCs encompasses a greater or lesser number of CIPs con SS.

  • Find out which MDC incorporating CIPs with SS carries a higher an average relative weight (RW).

Methods

  • Type of Study: prospective, analytical, longitudinal, and observational

  • Period: January 1-2011 / June 30-2014 (42 months)

SETTING

Medical/Surgical ICU

  • Population: 2559 CIPs admitted consecutively to the ICU; sample: 484 CIPs.

  • Exclusión criteria: CIPs < 16 y., major burn CIPs, incomplete clinical documentation, and voluntary discharge.

  • DRG AP-DRG 25.0 version (684 DRG are grouped into 25 MDC and 1 extra MDC).

  • Depending on the focus of sepsis, SS related to MDC '0' (precategoría) are transferred to another MDC.

  • MDC: 1 (neurology), 2 (eye), 3 (ear, nose, mouth, throat), 4 (respiratory), 5 (circulatory), 6 (digestive, 7 (hepatobiliary & pancreas), 8 (musculoskeletal & connective), 9 (skin & breast), 10 (endocrine), 11 (urinary tract), 12 (male reproductive), 13 (female reproductive), 14 (pregnancy & childbirth), 15 (newborn), 16: (blood & immunological), 17 (mMyeloproliferative), 18 (infectious), 19 (mental), 20 (alcohol / drug), 21 (Injuries & poison), 22 (burns), 23 (factors influencing health status), 24 (HIV), 25 (PLT), 0 (PreMed, miscellany)

Results

See Tables 1, 2 and 3.
Table 1

Results I

 

Global

%

SS

%

no SS

%

p value

CIPs

2559

100

484

18,8

2075

81,1

 

Age

65,9

 

73,5

 

64,1

 

0,001

Mortality

159

6,21

119

24,6

63

3,0

0,001

RW

4,21

 

7,9

 

3,35

 

0,001

Table 2

Results II.

MDC

SS

%

average RW

1

8

1,7

8,4598

4

114

24,0

11,0677

5

30

6,3

6,1961

6

152

32,0

9,9382

7

94

19,8

4,5068

Table 3

Results III.

MDC

SS

%

average RW

8

14

2,9

5,1191

9

8

1,7

4,0320

11

22

4,6

5,1687

18

33

6,9

3,7598

Global

475

100

7,9815

Excluded MDCs (< 8 DRG with SS): '2', '3', '4', '12','13', '14', '15', '16', '17', '19', '20', '21', '22', '23', '24' y '25'

Conclusions

  • 16 MDC do not identify SS (or less than 8 DRG).

  • MDC '6', '4' and '7' carry more SS, that, it respectively, correspond to the septic focus abdominal, respiratory, and biliopancreatic.

  • MDC '4' and '6' show the highest RW

References

  1. 1.
    Busse r, Geissler A, Quentin W, Wiley M: Diagnosis-Related Groups in Europe. Moving towards transparency, efficiency and quality in hospitals Open Univy Press. 2011, McGraw-Hill Education, England, European Observatory onHealth Systems and PoliciesGoogle Scholar
  2. 2.
    Homburg K, Rüst CA, Fodor P, Blumenthal S: Do Diagnosis Related Groups change admission practice to a large Swiss ICU?. Critical Care. 2013, 17 (Suppl 2): 484-Google Scholar

Copyright information

© Ruiz Moreno et al.; 2015

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Authors and Affiliations

  • J Ruiz Moreno
    • 1
  • E González Marín
    • 1
  • MJ Esteve Paños
    • 1
  • M Juliá Amill
    • 1
  • N Suárez Álvarez
    • 1
  • M Moral Guiteras
    • 1
  • F Baigorri González
    • 1
  • A Artigas Raventós
    • 2
  1. 1.QuirónSalud Hospital Universitario Sagrat CorCritical Care DepartmentBarcelonaSpain
  2. 2.Hospital de Sabadell & QuirónSalud Hospital Universitario Sagrat CorCritical Care DepartmentSabadellSpain

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