Document Detail

Revising diagnosis-related groups for neonates.
MedLine Citation:
PMID:  2500638     Owner:  NLM     Status:  MEDLINE    
Groups of neonates who are usually treated at hospitals that provide specialized pediatric care are not adequately classified by the use of diagnosis-related groups (DRGs). Therefore, a set of revised DRGs, pediatric modified DRGs (PM-DRGs), have been developed. Use of PM-DRGs substantially improves the classification of neonates in the following ways: a single pediatric modified major diagnostic category has been defined to include only and all neonates (patients younger than 29 days of age when admitted to the hospital); deaths and transfers of newborns are no longer combined into a single group; birth weight (rather than diagnosis) is used as the primary variable to differentiate categories of neonates; and duration of mechanical ventilation, presence of major problems, and surgery are used to define specific PM-DRGs. A total of 46 PM-DRGs have been developed to replace the 7 DRGs for neonates. Based on a sample of discharged patients from 13 children's hospitals, the overall variance reduction in duration of stay for neonates using PM-DRGs was 38.7% compared with 20.4% for DRGs. Variance reduction for PM-DRGs was 45.9% compared with 16.3% for DRGs when operating cost per case was used instead of duration of stay. After removing outliers at 150 days, the duration of stay variance reduction was 53.3% vs 23.6%, respectively, and the operating cost variance reduction was 58.8% vs 17.8%, respectively.
L K Lichtig; R A Knauf; A Bartoletti; L M Wozniak; R H Gregg; J Muldoon; W C Ellis
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  Pediatrics     Volume:  84     ISSN:  0031-4005     ISO Abbreviation:  Pediatrics     Publication Date:  1989 Jul 
Date Detail:
Created Date:  1989-08-03     Completed Date:  1989-08-03     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  49-61     Citation Subset:  AIM; IM    
Health Care Research Foundation, Inc, Albany, New York 12208.
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MeSH Terms
Birth Weight
Diagnosis-Related Groups*
Infant, Newborn
Infant, Newborn, Diseases / classification*,  diagnosis,  mortality,  surgery
Length of Stay
Patient Transfer
Respiration, Artificial
United States

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