Download - DRG Workshop Belgrade, 18-22.November 2013. Data Sets and the DRG grouper – RIC AND LINDY
DRG Workshop Belgrade, 18-22.November 2013.
WHY?????
• What are the data to be used for?
• What observations are needed?
• What data items are able to be retrieved?– How easy are they to abstract?– How consistent are they?– How comprehensive is the collection?
• Are valid? - relevant to the purpose?
• How reliable? - why are they recorded?
DRG Workshop Belgrade, 18-22.November 2013.
Hospital funding schemes in other countries
• GERMANY – CASEMIX (DRG) PAYMENT - iNEK• UK – (HRG) - PAYMENT BY RESULTS (PbR)• USA – DRG – PROSPECTIVE PAYMENT• SLOVENIA – DRG - SAME SERVICE SAME PRICE• HONG KONG – P4P• ABF = EPISODE PAYMENT =CASEMIX =PBR
=PFP =DRG FUNDING ..
DRG Workshop Belgrade, 18-22.November 2013.
Casemix Developmental ElementsCasemix Developmental Elements
DRG Workshop Belgrade, 18-22.November 2013.
DATA COLLECTIONS
• ACTIVITY DATA COLLECTIONS– Billing
• Fee for service claims datasets• episode of care datasets
– ‘Morbidity’ datasets• All activity from a provider datasets• Particular specialty area data• Particular phase of care or care-type data
• COSTING DATA COLLECTIONS• CLINICAL TRIALS DATA COLLECTIONS
DRG Workshop Belgrade, 18-22.November 2013.
PRIMARY CARE TYPE
AGE>70
PRINCIPAL INTENTION OF
CARE
FUNCTIONAL SCORE
<3
PDX CAT 1,2 OR 3
ADMITTED OR NON ADMITTEDCATEGORYSDX CAT
PROC CAT
DISPOSITION
COST DRIVERS
DRG Workshop Belgrade, 18-22.November 2013.
The National Minimum Data Set
• One reporting requirement multiple uses
• Complex process to maintain
• Stable and rigorous standards – but variable compliance
• Consistent and valid for comparisons
• Alternative is required DSS for payment.
• Convenient to maintain with NHDD
DRG Workshop Belgrade, 18-22.November 2013.
Establishing the National Health Data Dictionary
• Long term project multiple users– Consensus governance complex and slow– Eg US HIPAA law
• http://www.hhs.gov/ocr/privacy/hipaa/administrative/index.html
• Can have special purpose variants based on and mappable to the core data.
DRG Workshop Belgrade, 18-22.November 2013.
NATIONAL HEALTH DATA DICTIONARY
• KEY DATA ELEMENTS
• MINIMUM DATASET SPECIFICATIONS
• REPORTING REQUIREMENTS
• INTERNATIONAL AFFILIATION REFERENCES
• SUPPORTED BY – NATIONAL HEALTHCARE AGREEMENTS – PROVIDER CONTRACTS AND SLAs
DRG Workshop Belgrade, 18-22.November 2013.
Australia’s NHDD
http://www.google.com/search?client=safari&rls=en&q=national+health+data+dictionary+version+15&ie=UTF-8&oe=UTF-8
DRG Workshop Belgrade, 18-22.November 2013.
Data collection and reporting
• Using downloads from hospital Patient Administration Systems (PAS)
• Coding from clinical records and discharge summaries to PAS
• Web interfaced data entry systems
• Online edit and audit functions
• Data warehousing and data access
• Metadata management functions
DRG Workshop Belgrade, 18-22.November 2013.
INFORMATION SYSTEMS SCHEMA
SUPPLY HR FMIS PAS EHR
MPI
MHODS
AggregateAEDEMDESIS
MDSs
REPORTREPOSITORY
CUBESPIVOT
eg. COGNOS,BRIO, EXCELLeg. BUSINESS OBJECTSeg. SAS ,SPSS, STATA, ACCESS
BUSINESS LAYER
DATAWAREHOUSE
REPORTING LAYER (MIS)
STATISTICAL ANALYSIS
MHCMI
MHDW
eg. Oracle, SAP, etc