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The hypothesis of present study is that the daily monitoring and optimization of DRG coding is associated with higher reimbursement. Therefore, the primary objective is to determine if the daily monitoring and optimization of DRG coding of individual cases leads to better proceeds per day.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Control arm | standard procedure of coding at hospital |
| |
| Precoding arm | Coding of the standard procedure will be reviewed and corrected |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Standard procedure | Other | Coding of cases follows the standard procedures established at the hospital |
|
| Measure | Description | Time Frame |
|---|---|---|
| reimbursement per day at hospital | total reimbursement per arm divided by the total stay of the patients in the arm in days | 8 months |
| Measure | Description | Time Frame |
|---|---|---|
| Length of hospital stay | length of hopital stay in full days including entry and discharge day | 8 months |
| Total reimbursement per case | reimbursement in Swiss Francs per case |
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Inclusion Criteria:
Exclusion Criteria:
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patients undergoing inpatient surgery in the fields of General, Visceral, Endocrine or Transplantation Surgery
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| Name | Affiliation | Role |
|---|---|---|
| Thomas Steffen, MD | Cantonal Hospital of St. Gallen | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Department of Surgery, Cantonal Hospital of St. Gallen | Sankt Gallen | 9007 | Switzerland |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 12410910 | Background | Fillit H, Geldmacher DS, Welter RT, Maslow K, Fraser M. Optimizing coding and reimbursement to improve management of Alzheimer's disease and related dementias. J Am Geriatr Soc. 2002 Nov;50(11):1871-8. doi: 10.1046/j.1532-5415.2002.50519.x. | |
| 10311457 | Background | Fetter RB, Freeman JL. Diagnosis related groups: product line management within hospitals. Acad Manage Rev. 1986 Jan;11(1):41-54. |
| Label | URL |
|---|---|
| OnlineGrouper | View source |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | May 24, 2019 |
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| precoding | Other | Standard coding will be reviewed by dedicated physicians and corrected or extended if necessary. Coding will compared to the written OP report for consistency. Dedicated physician visits patients daily (in addition to routine visits). Dedicated physicians review discharge report and will make changes and additions. DRG coding will be adapted to results from visits and discharge report. |
|
| 8 months |
| case mix index per case | Financial department will provide the cost weight/case mix index per case | 8 months |
| Severity of perioperative complications | complications during hospitalisation will be graded according to the Clavian-Dindo scale. In case of multiple complications the highest grade will be taken. | 8 months |
| readmission rate | Rate of case related readmissions | 8 months |
| 1288673 | Background | Fetter RB. Hospital payment based on diagnosis-related groups. J Soc Health Syst. 1992;3(4):4-15. |
| 7637403 | Background | Freeman JL, Fetter RB, Park H, Schneider KC, Lichtenstein JL, Hughes JS, Bauman WA, Duncan CC, Freeman DH Jr, Palmer GR. Diagnosis-related group refinement with diagnosis- and procedure-specific comorbidities and complications. Med Care. 1995 Aug;33(8):806-27. doi: 10.1097/00005650-199508000-00006. |
| 10113461 | Background | Hughes JS, Lichtenstein J, Fetter RB. Procedure codes: potential modifiers of diagnosis-related groups. Health Care Financ Rev. 1990 Fall;12(1):39-46. |
| 29188352 | Background | Geuss S, Jungmeister A, Baumgart A, Seelos R, Ockert S. [Prospective DRG coding : Improvement in cost-effectiveness and documentation quality of in-patient hospital care]. Chirurg. 2018 Feb;89(2):138-145. doi: 10.1007/s00104-017-0555-4. German. |
| 15273542 | Background | Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004 Aug;240(2):205-13. doi: 10.1097/01.sla.0000133083.54934.ae. |
| 19638912 | Background | Clavien PA, Barkun J, de Oliveira ML, Vauthey JN, Dindo D, Schulick RD, de Santibanes E, Pekolj J, Slankamenac K, Bassi C, Graf R, Vonlanthen R, Padbury R, Cameron JL, Makuuchi M. The Clavien-Dindo classification of surgical complications: five-year experience. Ann Surg. 2009 Aug;250(2):187-96. doi: 10.1097/SLA.0b013e3181b13ca2. |
| Common Terminology Criteria for Adverse Events (CTCAE) | View source |
| Jan 22, 2021 |
| Prot_SAP_000.pdf |