A New Diagnosis-Related Group for Palliative Care

1997 ◽  
Vol 336 (14) ◽  
pp. 1029-1030 ◽  
Keyword(s):  
Palliative Care ◽  
Diagnosis Related Group ◽  
Related Group ◽  
New Diagnosis

scholarly journals The New Diagnosis-Related Group Reimbursement System and Laboratory Test Quality in Korea: Analysis of External Quality Assessment Results

Healthcare ◽  
2020 ◽  
Vol 8 (2) ◽  
pp. 127 ◽  
Author(s):  
Sollip Kim ◽  
Yeo-Min Yun ◽  
Hyeongsu Kim ◽  
Tae-Hyun Um ◽  
Jeonghyun Chang ◽  
...  
Keyword(s):  
Laboratory Test ◽  
Quality Assessment ◽  
External Quality Assessment ◽  
Public Hospitals ◽  
Diagnosis Related Group ◽  
Reimbursement System ◽  
Test Quality ◽  
External Quality ◽  
Related Group ◽  
New Diagnosis

Korea introduced a new diagnosis-related group (NDRG), which is a mixed-bundle reimbursement system. We evaluated the effects of NDRGs on laboratory test quality by analyzing data over three years (2016–2018) from the Korean Association of External Quality Assessment Service (KEQAS). A total of 42 NDRG-participating hospitals (CASE), 84 non-participating similar size-hospitals (CON-1), and 42 tertiary hospitals (CON-2) were included. We assumed the proportion of KEQAS results with a larger than 2 standard deviation index (SDI) to be a bad laboratory quality marker (BLQM). CASE BLQMs were lower than CON-1 BLQMs for more than 2 years in alkaline phosphatase (ALP), alanine aminotransferase (ALT), chloride, glucose, sodium, and total protein, and higher in creatinine. CASE BLQMs were higher than CON-2 BLQMs for more than 2 years in ALP, chloride, creatinine, glucose, lactate dehydrogenase (LDH), phosphorus, potassium, sodium, total calcium, total cholesterol, triglyceride, and uric acid. Mean SDIs for general chemistry tests were not significantly different depending on NDRG participation. However, the NDRG is currently a pilot program that compensates the amount of each institution’s reimbursement based on the fee-for-service system, and most participants were public hospitals. Thus, the effects of NDRGs on laboratory test quality should be re-evaluated after the NDRG program has stabilized and more private hospitals are participating.

scholarly journals Physicians’ Understanding of the New Diagnosis-Related Group (NDRG) Payment System According to NDRG Participation

2021 ◽  
Vol 11 (1) ◽  
pp. 47-54
Author(s):  
Misuk Ji ◽  
Yong-jun Choi ◽  
Sollip Kim ◽  
Yeo-Min Yun ◽  
Tae Hyun Um ◽  
...  
Keyword(s):  
Payment System ◽  
Diagnosis Related Group ◽  
Related Group ◽  
New Diagnosis

scholarly journals Qualitative study to explore what patients with heart failure find significant during integrated palliative care sessions in a Danish clinic

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e043955
Author(s):  
Stine Gundtoft Roikjær ◽  
Charlotte Paaske Simonÿ ◽  
Helle Ussing Timm
Keyword(s):  
Heart Failure ◽  
Palliative Care ◽  
Meaning Making ◽  
Interview Study ◽  
Exclusion Criterion ◽  
Semistructured Interview ◽  
Patients With Heart Failure ◽  
New Diagnosis ◽  
Medical Perspective

ObjectiveIn the field of palliative care (PC) as it is integrated into heart failure (HF) treatment, it is essential to explore the patient experience and build on this knowledge for the further development of PC practice and policy. Based on an intervention study, this paper explores what patients with HF find significant in integrated sessions using a narrative S’ approach.DesignWe conducted a semistructured interview study with a qualitative analysis focused on meaning making. The study follows the guidelines of Consolidated Criteria for Reporting Qualitative Research.Participants and settingThe inclusion criteria for the PC intervention were (1) a new diagnosis of HF, (2) follow-up treatment at this local Danish HF clinic and (3) informed consent to participate in the integrated PC intervention. The only exclusion criterion was if the patient was already engaged in a PC programme. 20 patients agreed to participate in the intervention, and 12 of these completed the S’ approach sessions and participated in this interview study.ResultsOverall, the analysis showed that the integrated S’ approach sessions were successful in joining an embodied patient perspective with a medical perspective. The thematic analysis resulted in three themes supporting the overall findings: sessions bring comfort, telling your story provides a sense of meaningfulness, and integrating perspectives of HF into everyday life.ConclusionThe method using the S’ approach in integrated PC and HF sessions was significant in various ways. First, patients experienced a calm and safe atmosphere and perceived that the nurse was truly interested in them. Second, the integrated sessions based on the S’ approach were able to bring comfort to lived physical, psychosocial and existential issues. Last, it allowed patients to combine their embodied understanding of HF with a medical perspective, thereby finding meaning in the sense of how everything is connected.

scholarly journals Diagnosis-related group-based reimbursement is unrealistic for ICUs

Critical Care ◽  
2009 ◽  
Vol 13 (Suppl 1) ◽  
pp. P485
Author(s):  
A Mclaughlin ◽  
J Hardt ◽  
J Canavan ◽  
MB Donnelly
Keyword(s):  
Diagnosis Related Group ◽  
Related Group

A review of the complexity adjustment in the Korean Diagnosis-Related Group (KDRG)

2018 ◽  
Vol 49 (1) ◽  
pp. 62-68 ◽  
Author(s):  
Sujeong Kim ◽  
Chaiyoung Jung ◽  
Junheum Yon ◽  
Hyeonseon Park ◽  
Hunsik Yang ◽  
...  
Keyword(s):  
Diagnosis Related Groups ◽  
Claim Data ◽  
Hospital Charge ◽  
Diagnosis Related Group ◽  
Cost Data ◽  
Hospital Charges ◽  
Average Charge ◽  
Average Hospital ◽  
Adjustment Mechanism ◽  
Related Group

Background: The Korean Diagnosis-Related Groups (KDRG) was revised in 2003, modifying the complexity adjustment mechanism of the Australian Refined Diagnosis-Related Groups (AR-DRGs). In 2014, the Complication and Comorbidity Level (CCL) of the existing AR-DRG system was found to have very little correlation with cost. Objective: Based on the Australian experience, the CCL for KDRG version 3.4 was reviewed. Method: Inpatient claim data for 2011 were used in this study. About 5,731,551 episodes, which had one or no complication and comorbidity (CC) and met the inclusion criteria, were selected. The differences of average hospital charges by the CCL were analysed in each Adjacent Diagnosis-Related Group (ADRG) using analysis of variance followed by Duncan’s test. The patterns of differences were presented with R 2 in three patterns: The CCL reflected the complexity well (VALID); the average charge of CCL 2, 3, 4 was greater than CCL 0 (PARTIALLY VALID); the CCL did not reflect the complexity (NOT VALID). Results: A total of 114 (19.03%), 190 (31.72%) and 295 (49.25%) ADRGs were included in VALID, PARTIALLY VALID and NOT VALID, respectively. The average R 2 for hospital charge of CCL was 4.94%. The average R 2 in VALID, PARTIALLY VALID and NOT VALID was 4.54%, 5.21%, and 4.93%, respectively. Conclusion: The CCL, the first step of complexity adjustment using secondary diagnoses, exhibited low performance. If highly accurate coding data and cost data become available, the performance of secondary diagnosis as a variable to reflect the case complexity should be re-evaluated. Implications: Lack of reviewing the complexity adjustment mechanism of the KDRG since 2003 has resulted in outdated CC lists and levels that no longer reflect the current Korean healthcare system. Reliable cost data (vs. charge) and accurate coding are essential for accuracy of reimbursement.

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