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Volume 3 Supplement 1

ESICM LIVES 2015

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

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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
Table 2 Results II.
Table 3 Results III.

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 Policies

  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-

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Author information

Correspondence to J Ruiz Moreno.

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Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0), which permits use, duplication, adaptation, distribution, and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

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Ruiz Moreno, J., González Marín, E., Esteve Paños, M. et al. Distribution of critically ill patients (CIP) with severe sepsis (SS) according to the major diagnostic categories (MDC) of the diagnosis-related groups (DRG). ICMx 3, A735 (2015) doi:10.1186/2197-425X-3-S1-A735

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Keywords

  • Public Health
  • Alcohol
  • Severe Sepsis
  • Competitive Advantage
  • Relative Weight