PMID- 31506190
OWN - NLM
STAT- MEDLINE
DCOM- 20200915
LR  - 20200915
IS  - 1872-6054 (Electronic)
IS  - 0168-8510 (Linking)
VI  - 123
IP  - 11
DP  - 2019 Nov
TI  - A new clinical complexity model for the Australian Refined Diagnosis Related 
      Groups.
PG  - 1049-1052
LID - S0168-8510(19)30202-7 [pii]
LID - 10.1016/j.healthpol.2019.08.012 [doi]
AB  - BACKGROUND: The Australian Refined Diagnosis Related Groups (AR-DRG) underwent a 
      major review in 2014 with changes implemented in Version 8.0 of the 
      classification. The core to the changes was the development of a new methodology 
      to estimate the Diagnosis Complexity Level (DCL) and to aggregate the complexity 
      level of individual diagnoses to the complexity of an entire episode, resulting 
      in an Episode Clinical Complexity Score (ECCS). This paper provides an overview 
      of the new methodology and its application in Version 8.0. METHOD: The AR-DRG 
      V8.0 refinement project was overseen by a Classifications Clinical Advisory Group 
      and a Diagnosis Related Groups (DRG) Technical Group. Admitted Patient Care 
      National Minimum Dataset and the National Hospital Cost Data Collection were used 
      for complexity modelling and analysis. RESULT: In total, Version 8.0 comprised 
      807 DRGs, including 3 error DRGs. Of the 321 Adjacent DRGs (ADRGs) that had a 
      split, 315 ADRGs used ECCS as the only splitting variable while the remaining 6 
      ADRGs used splitting variables other than ECCS: 2 used age and 4 used transfer. 
      DISCUSSION AND CONCLUSION: A new episode clinical complexity (ECC) model was 
      developed and introduced in AR-DRG V8.0, replacing the original model introduced 
      in the 1990s. Clear AR-DRG structure principles were established for revising the 
      system. The new complexity model is conceptually based and statistically derived, 
      and results in an improved relationship with actual variations in resource use 
      due to episode complexity.
CI  - Copyright (c) 2019. Published by Elsevier B.V.
FAU - Dimitropoulos, Vera
AU  - Dimitropoulos V
AD  - National Centre for Classification in Health, University of Sydney, Australia.
FAU - Yeend, Trent
AU  - Yeend T
AD  - Australian Institute of Health Innovation, Macquarie University, Australia.
FAU - Zhou, Qingsheng
AU  - Zhou Q
AD  - National Centre for Classification in Health, University of Sydney, Australia. 
      Electronic address: Qingsheng.zhou@sydney.edu.au.
FAU - McAlister, Stuart
AU  - McAlister S
AD  - Independent Consultant, Australia.
FAU - Navakatikyan, Michael
AU  - Navakatikyan M
AD  - Population Wellbeing and Environment Research Lab., University of Wollongong, 
      Australia.
FAU - Hoyle, Philip
AU  - Hoyle P
AD  - Royal North Shore Hospital, Sydney, Australia.
FAU - Pilla, John
AU  - Pilla J
AD  - Independent Consultant, Australia.
FAU - Loggie, Carol
AU  - Loggie C
AD  - Centre for Health Service Development, University of Wollongong, Australia.
FAU - Elsworthy, Anne
AU  - Elsworthy A
AD  - Independent Hospital Pricing Authority, Australia.
FAU - Marshall, Ric
AU  - Marshall R
AD  - National Centre for Classification in Health, University of Sydney, Australia.
FAU - Madden, Richard
AU  - Madden R
AD  - National Centre for Classification in Health, University of Sydney, Australia.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20190824
PL  - Ireland
TA  - Health Policy
JT  - Health policy (Amsterdam, Netherlands)
JID - 8409431
MH  - Australia
MH  - *Diagnosis-Related Groups/economics/statistics & numerical data
MH  - *Episode of Care
MH  - *Hospital Costs
MH  - Hospitalization
MH  - Humans
MH  - Models, Statistical
MH  - *National Health Programs/economics/statistics & numerical data
OTO - NOTNLM
OT  - Activity Based Funding (ABF)
OT  - Australian Refined Diagnosis Related Groups (AR-DRG)
OT  - Casemix
OT  - Diagnosis Complexity Level (DCL)
OT  - Episode Clinical Complexity Score (ECCS)
OT  - Hospital resource utilisation
EDAT- 2019/09/12 06:00
MHDA- 2020/09/17 06:00
CRDT- 2019/09/12 06:00
PHST- 2019/04/17 00:00 [received]
PHST- 2019/08/07 00:00 [revised]
PHST- 2019/08/19 00:00 [accepted]
PHST- 2019/09/12 06:00 [pubmed]
PHST- 2020/09/17 06:00 [medline]
PHST- 2019/09/12 06:00 [entrez]
AID - S0168-8510(19)30202-7 [pii]
AID - 10.1016/j.healthpol.2019.08.012 [doi]
PST - ppublish
SO  - Health Policy. 2019 Nov;123(11):1049-1052. doi: 10.1016/j.healthpol.2019.08.012. 
      Epub 2019 Aug 24.