PMID- 31445263
OWN - NLM
STAT- MEDLINE
DCOM- 20191129
LR  - 20191129
IS  - 1872-8243 (Electronic)
IS  - 1386-5056 (Linking)
VI  - 129
DP  - 2019 Sep
TI  - The impact of improving the quality of coding in the utilities of Diagnosis 
      Related Groups system in a private healthcare institution. 14-year experience.
PG  - 248-252
LID - S1386-5056(19)30176-5 [pii]
LID - 10.1016/j.ijmedinf.2019.06.019 [doi]
AB  - BACKGROUND AND PROJECT AIM: The American British Cowdray Medical Center is a 
      private healthcare institution in Mexico City. One of the many tools that we use 
      and help us to achieve a high standard of quality and recognition worldwide is 
      the clinical coding and Diagnosis Related Groups (DRG). To help the readers to 
      improve the process of clinical coding, we will share the challenges, changes and 
      different applications of the generation of DRG in the private healthcare 
      institution. METHODS AND RESULTS: A retrospective, descriptive study to 
      demonstrate the changes on the process of coding and measure the outcome of 
      clinical coding, precision of data and better quality in the generations of DRGs. 
      Initially, less than 2 diagnoses and 1 procedure were coded per discharge, using 
      partial medical records. By the second half of 2007, a different coding procedure 
      was implemented, and the complete medical records started being used; also, 
      comorbid conditions were included in coding. Nowadays, the average number of 
      coded diagnoses is 5.4 and the average number of coded procedures is 4.2, with a 
      coding error rate of 0.68% and a DRG outliers' rate of 0.45%. DISCUSSION AND 
      CONCLUSIONS: While many countries use DRG for reimbursement, we exploit the 
      clinical data registration and the DRGs for the economic and organizational. 
      Through more efficient and accurate coding, DRGs are useful within the 
      institution to generate indicators on resources, cost, length of stay and goals 
      for each service. Having better quality clinical data has allowed for improved 
      service line management, which has translated into patient-oriented services. 
      Prospective studies are necessary to keep evaluating in a objective way the 
      utilities of the DRG in healthcare private institutions.
CI  - Copyright (c) 2019 Elsevier B.V. All rights reserved.
FAU - Garcia Calderon, Venancio
AU  - Garcia Calderon V
AD  - Clinical Archive Department, American British Cowdray Medical Center, CDMX, 
      Mexico.
FAU - Figueiras Huante, Ivan Alejandro
AU  - Figueiras Huante IA
AD  - Clinical Archive Department, American British Cowdray Medical Center, CDMX, 
      Mexico.
FAU - Carbajal Martinez, Miguel
AU  - Carbajal Martinez M
AD  - Clinical Archive Department, American British Cowdray Medical Center, CDMX, 
      Mexico.
FAU - Yacaman Handal, Reyna Elizabeth
AU  - Yacaman Handal RE
AD  - Quallity Control Department, American British Cowdray Medical Center, CDMX, 
      Mexico.
FAU - Palami Antunez, Diana
AU  - Palami Antunez D
AD  - Quallity Control Department, American British Cowdray Medical Center, CDMX, 
      Mexico.
FAU - Soto, Maria Elena
AU  - Soto ME
AD  - Research Department of American British Cowdray Medical Center, Mexico CDMX and 
      Immunology Department, Instituto Nacional de Cardiologia "Ignacio Chavez", CDMX, 
      Mexico.
FAU - Koretzky, Solange Gabriela
AU  - Koretzky SG
AD  - Quallity Control Department, American British Cowdray Medical Center, CDMX, 
      Mexico. Electronic address: sgkoretzky@abchospital.com.
LA  - eng
PT  - Journal Article
DEP - 20190622
PL  - Ireland
TA  - Int J Med Inform
JT  - International journal of medical informatics
JID - 9711057
SB  - IM
MH  - *Clinical Coding
MH  - Costs and Cost Analysis
MH  - Diagnosis-Related Groups
MH  - Hospitals
MH  - Humans
MH  - Medical Records
MH  - Patient Discharge/economics
MH  - Prospective Studies
MH  - Retrospective Studies
MH  - Time Factors
OTO - NOTNLM
OT  - Challenge
OT  - Clinical coding
OT  - Diagnosis Related Groups
OT  - Internal administration improve
OT  - Private healthcare
EDAT- 2019/08/25 06:00
MHDA- 2019/11/30 06:00
CRDT- 2019/08/25 06:00
PHST- 2019/02/18 00:00 [received]
PHST- 2019/06/19 00:00 [revised]
PHST- 2019/06/20 00:00 [accepted]
PHST- 2019/08/25 06:00 [pubmed]
PHST- 2019/11/30 06:00 [medline]
PHST- 2019/08/25 06:00 [entrez]
AID - S1386-5056(19)30176-5 [pii]
AID - 10.1016/j.ijmedinf.2019.06.019 [doi]
PST - ppublish
SO  - Int J Med Inform. 2019 Sep;129:248-252. doi: 10.1016/j.ijmedinf.2019.06.019. Epub 
      2019 Jun 22.