PMID- 24670543
OWN - NLM
STAT- MEDLINE
DCOM- 20140603
LR  - 20140327
IS  - 1012-5302 (Print)
IS  - 1012-5302 (Linking)
VI  - 27
IP  - 2
DP  - 2014 Apr
TI  - [Variability in nursing workload within Swiss Diagnosis Related Groups].
PG  - 105-15
LID - 10.1024/1012-5302/a000350 [doi]
AB  - Nursing care inputs represent one of the major cost components in the Swiss 
      Diagnosis Related Group (DRG) structure. High and low nursing workloads in 
      individual cases are supposed to balance out via the DRG group. Research results 
      indicating possible problems in this area cannot be reliably extrapolated to 
      SwissDRG. An analysis of nursing workload figures with DRG indicators was carried 
      out in order to decide whether there is a need to develop SwissDRG classification 
      criteria that are specific to nursing care. The case groups were determined with 
      SwissDRG 0.1, and nursing workload with LEP Nursing 2. Robust statistical methods 
      were used. The evaluation of classification accuracy was carried out with R2 as 
      the measurement of variance reduction and the coefficient of homogeneity (CH). To 
      ensure reliable conclusions, statistical tests with bootstrapping methods were 
      performed. The sample included 213 groups with a total of 73930 cases from ten 
      hospitals. The DRG classification was seen to have limited explanatory power for 
      variability in nursing workload inputs, both for all cases (R2 = 0.16) and for 
      inliers (R2 = 0.32). Nursing workload homogeneity was statistically significant 
      unsatisfactory (CH < 0.67) in 123 groups, including 24 groups in which it was 
      significant defective (CH < 0.60). Therefore, there is a high risk of high and 
      low nursing workloads not balancing out in these groups, and, as a result, of 
      financial resources being wrongly allocated. The development of 
      nursing-care-specific SwissDRG classification criteria for improved homogeneity 
      and variance reduction is therefore indicated.
FAU - Baumberger, Dieter
AU  - Baumberger D
AD  - Department fur Pflegewissenschaft, Universitat Witten/Herdecke.
FAU - Burgin, Reto
AU  - Burgin R
AD  - Institut d'Etudes Demographiques et du Parcours de Vie, Universite de Geneve.
FAU - Bartholomeyczik, Sabine
AU  - Bartholomeyczik S
AD  - Department fur Pflegewissenschaft, Universitat Witten/Herdecke.
LA  - ger
PT  - English Abstract
PT  - Journal Article
TT  - Variabilitat des Pflegeaufwands in SwissDRG-Fallgruppen.
PL  - Switzerland
TA  - Pflege
JT  - Pflege
JID - 8907069
MH  - Attitude of Health Personnel
MH  - Diagnosis-Related Groups/classification/*statistics & numerical data
MH  - Humans
MH  - *National Health Programs
MH  - Nursing Staff, Hospital/*statistics & numerical data
MH  - Switzerland
MH  - Workload/*statistics & numerical data
OTO - NOTNLM
OT  - Diagnosis-Related Groups
OT  - Klassifikation
OT  - Pflegeaufwand
OT  - Varianzanalyse
OT  - analysis of variance
OT  - classification
OT  - diagnosebezogene Fallgruppen
OT  - economic homogeneity
OT  - nursing workload
OT  - okonomische Homogenitat
EDAT- 2014/03/29 06:00
MHDA- 2014/06/04 06:00
CRDT- 2014/03/28 06:00
PHST- 2014/03/28 06:00 [entrez]
PHST- 2014/03/29 06:00 [pubmed]
PHST- 2014/06/04 06:00 [medline]
AID - A1W64R7454245575 [pii]
AID - 10.1024/1012-5302/a000350 [doi]
PST - ppublish
SO  - Pflege. 2014 Apr;27(2):105-15. doi: 10.1024/1012-5302/a000350.