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Data Sets and the DRG grouper –

Data Sets and the DRG grouper –. RIC AND LINDY. WHY?????. What are the data to be used for? What observations are needed? What data items are able to be retrieved? How easy are they to abstract? How consistent are they? How comprehensive is the collection?

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Data Sets and the DRG grouper –

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  1. Data Sets and the DRG grouper – RIC AND LINDY

  2. WHY????? • What are the data to be used for? • What observations are needed? • What data items are able to be retrieved? • How easy are they to abstract? • How consistent are they? • How comprehensive is the collection? • Are valid? - relevant to the purpose? • How reliable? - why are they recorded?

  3. Hospital funding schemes in other countries • GERMANY – CASEMIX (DRG) PAYMENT - iNEK • UK – (HRG) - PAYMENT BY RESULTS (PbR) • USA – DRG – PROSPECTIVE PAYMENT • SLOVENIA – DRG - SAME SERVICE SAME PRICE • HONG KONG – P4P • ABF = EPISODE PAYMENT =CASEMIX =PBR =PFP =DRG FUNDING ..

  4. Casemix Developmental Elements

  5. PERFORMANCE ELEMENTS (HK) DRG

  6. DATA COLLECTIONS • ACTIVITY DATA COLLECTIONS • Billing • Fee for service claims datasets • episode of care datasets • ‘Morbidity’ datasets • All activity from a provider datasets • Particular specialty area data • Particular phase of care or care-type data • COSTING DATA COLLECTIONS • CLINICAL TRIALS DATA COLLECTIONS

  7. ATS/PAS Data Concepts

  8. COST DRIVERS ADMITTED OR NON ADMITTED CATEGORY AGE >70 SDX CAT PROC CAT PRINCIPAL INTENTION OF CARE PRIMARY CARE TYPE DISPOSITION PDX CAT 1,2 OR 3 FUNCTIONAL SCORE <3

  9. The National Minimum Data Set • One reporting requirement multiple uses • Complex process to maintain • Stable and rigorous standards – but variable compliance • Consistent and valid for comparisons • Alternative is required DSS for payment. • Convenient to maintain with NHDD

  10. Establishing the National Health Data Dictionary • Long term project multiple users • Consensus governance complex and slow • Eg US HIPAA law • http://www.hhs.gov/ocr/privacy/hipaa/administrative/index.html • Can have special purpose variants based on and mappable to the core data.

  11. NATIONAL HEALTH DATA DICTIONARY • KEY DATA ELEMENTS • MINIMUM DATASET SPECIFICATIONS • REPORTING REQUIREMENTS • INTERNATIONAL AFFILIATION REFERENCES • SUPPORTED BY • NATIONAL HEALTHCARE AGREEMENTS • PROVIDER CONTRACTS AND SLAs

  12. Australia’s NHDD http://www.google.com/search?client=safari&rls=en&q=national+health+data+dictionary+version+15&ie=UTF-8&oe=UTF-8

  13. Example of a Data element

  14. Data collection and reporting • Using downloads from hospital Patient Administration Systems (PAS) • Coding from clinical records and discharge summaries to PAS • Web interfaced data entry systems • Online edit and audit functions • Data warehousing and data access • Metadata management functions

  15. INFORMATION SYSTEMS SCHEMA eg. COGNOS,BRIO, EXCELL eg. BUSINESS OBJECTS eg. SAS ,SPSS, STATA, ACCESS CUBES PIVOT REPORT REPOSITORY REPORTING LAYER (MIS) STATISTICAL ANALYSIS DATA WAREHOUSE AED EMD ESIS Aggregate MH DW MH ODS MDSs MH CMI MPI eg. Oracle, SAP, etc SUPPLY HR FMIS PAS EHR BUSINESS LAYER

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