Producing DRG Statistics at the European Level: Lessons from the EURODRG Project

Casas, Mercè; Tomàs, Rosa

doi:10.1007/978-3-642-78472-9_5

“…However, the presence of high outliers produces the greatest threat to these assumptions in casemix work. This is reflected in the fact that the R 2 values based on untrimmed data may be more than 20 percentage points lower than when the outliers are removed (Casas and Tomas, 1993;Palmer et al, 1997). Similarly, the proportion of cases removed as outliers also will have a substantial impact on the value of R 2 .…”

Section: Predictive Validitymentioning

confidence: 99%

“…Evidence was presented that the limited reporting of secondary diagnoses in Europe was the main reason for the relatively poor performance of R-DRGs compared with the findings for both versions of DRGs based on US data. Casas and Tomas (1993) used data from Ireland, Portugal, Switzerland and Spain to assess the performance of AP-DRGs and also to compare the ALOS for individual AP-DRGs between the countries. The IQR was used to trim each dataset using both log-transformed and untransformed LOS data.…”

Section: Review Of Published Reports On Drg Performancementioning

confidence: 99%

Evaluation of the Performance of Diagnosis-Related Groups and Similar Casemix Systems: Methodological Issues

Palmer

¹

,

Reid

²

2001

Health Serv Manage Res

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With the increasing recognition and application of casemix for managing and financing healthcare resources, the evaluation of alternative versions of systems such as diagnosis-related groups (DRGs) has been afforded high priority by governments and researchers in many countries. Outside the United States, an important issue has been the perceived need to produce local versions, and to establish whether or not these perform more effectively than the US-based classifications. A discussion of casemix evaluation criteria highlights the large number of measures that may be used, the rationale and assumptions underlying each measure, and the problems in interpreting the results. A review of recent evaluation studies from a number of countries indicates that considerable emphasis has been placed on the predictive validity criterion, as measured by the R2 statistic. However, the interpretation of the findings has been affected greatly by the methods used, especially the treatment and definition of outlier cases. Furthermore, the extent to which other evaluation criteria have been addressed has varied widely. In the absence of minimum evaluation standards, it is not possible to draw clear-cut conclusions about the superiority of one version of a casemix system over another, the need for a local adaptation, or the further development of an existing version. Without the evidence provided by properly designed studies, policy-makers and managers may place undue reliance on subjective judgments and the views of the most influential, but not necessarily best informed, healthcare interest groups.

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“…However, the presence of high outliers produces the greatest threat to these assumptions in casemix work. This is re¯ected in the fact that the R 2 values based on untrimmed data may be more than 20 percentage points lower than when the outliers are removed (Casas and Tomas, 1993;Palmer et al, 1997). Similarly, the proportion of cases removed as outliers also will have a substantial impact on the value of R 2 .…”

Section: Predictive Validitymentioning

confidence: 99%

“…Evidence was presented that the limited reporting of secondary diagnoses in Europe was the main reason for the relatively poor performance of R-DRGs compared with the ®ndings for both versions of DRGs based on US data. Casas and Tomas (1993) used data from Ireland, Portugal, Switzerland and Spain to assess the performance of AP-DRGs and also to compare the ALOS for individual AP-DRGs between the countries. The IQR was used to trim each dataset using both log-transformed and untransformed LOS data.…”

Section: Review Of Published Reports On Drg Performancementioning

confidence: 99%

Evaluation of the performance of diagnosis-related groups and similar casemix systems: methodological issues

Palmer

¹

,

Reid

²

2001

Health Serv Manage Res

View full text Add to dashboard Cite

With the increasing recognition and application of casemix for managing and financing healthcare resources, the evaluation of alternative versions of systems such as diagnosis-related groups (DRGs) has been afforded high priority by governments and researchers in many countries. Outside the United States, an important issue has been the perceived need to produce local versions, and to establish whether or not these perform more effectively than the US-based classifications. A discussion of casemix evaluation criteria highlights the large number of measures that may be used, the rationale and assumptions underlying each measure, and the problems in interpreting the results. A review of recent evaluation studies from a number of countries indicates that considerable emphasis has been placed on the predictive validity criterion, as measured by the R2 statistic. However, the interpretation of the findings has been affected greatly by the methods used, especially the treatment and definition of outlier cases. Furthermore, the extent to which other evaluation criteria have been addressed has varied widely. In the absence of minimum evaluation standards, it is not possible to draw clear-cut conclusions about the superiority of one version of a casemix system over another, the need for a local adaptation, or the further development of an existing version. Without the evidence provided by properly designed studies, policy-makers and managers may place undue reliance on subjective judgments and the views of the most influential, but not necessarily best informed, healthcare interest groups.

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“…It is an essential method for evaluation to use local data to analyze the performance of local or foreign DRGs versions. In the 1990s, this type of study was carried out in many European countries (Freeman, ; Casas and Tomas, ). Since then, more DRGs versions have been developed.…”

Section: Introductionmentioning

confidence: 99%

Evaluating performance of local case-mix system by international comparison: a case study in Beijing, China

Jian

¹

,

Lu

²

,

Tao

³

et al. 2011

Int J Health Plann Mgmt

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Producing DRG Statistics at the European Level: Lessons from the EURODRG Project

Cited by 5 publications

References 9 publications

Evaluation of the Performance of Diagnosis-Related Groups and Similar Casemix Systems: Methodological Issues

Evaluation of the Performance of Diagnosis-Related Groups and Similar Casemix Systems: Methodological Issues

Evaluation of the performance of diagnosis-related groups and similar casemix systems: methodological issues

Evaluating performance of local case-mix system by international comparison: a case study in Beijing, China

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