Most Frequent Diagnoses and Procedures for DRGs, by Insurance Status

Most Frequent Diagnoses and Procedures for DRGs, by Insurance Status PDF Author: Anne Elixhauser
Publisher:
ISBN:
Category : Diagnosis related groups
Languages : en
Pages : 140

Book Description
Contains information on the most frequent diagnosis and procedures for the top 50 diagnosis-related groups in the United States community hospitals. For each entry, the most common principal diagnosis and most common performed principal procedures are listed. Charges and length of stay are listed for each combination. Results are detailed by insurance status: privately insured, Medicaid, and self-pay patients.

Most Frequent Diagnoses And Procedures For Drgs, By Insurance Status

Most Frequent Diagnoses And Procedures For Drgs, By Insurance Status PDF Author: Cassandra Swartz
Publisher:
ISBN: 9780788142468
Category : Medical
Languages : en
Pages : 132

Book Description
Contains information, drawn from a nationwide administrative database, on the most frequent combinations of diagnoses and procedures for hospital inpatients, by insurance status. Separate results are presented for privately insured, Medicaid, and self-pay patients. For each of the 50 most frequent DRGs, the 5 principal diagnoses most commonly recorded on patient discharge abstracts are listed, as well as the 5 principal procedures most commonly performed within each DRG. Estimated mean and median charges and length of stay are provided for each combination, along with their standard errors.

Most Frequent Diagnoses and Procedures for DRGs, by Insurance Status

Most Frequent Diagnoses and Procedures for DRGs, by Insurance Status PDF Author: Anne Elixhauser
Publisher:
ISBN:
Category :
Languages : en
Pages :

Book Description


Transition to Diagnosis-Related Group (DRG) Payments for Health

Transition to Diagnosis-Related Group (DRG) Payments for Health PDF Author: Caryn Bredenkamp
Publisher: World Bank Publications
ISBN: 1464815216
Category : Medical
Languages : en
Pages : 69

Book Description
This book examines how nine different health systems--U.S. Medicare, Australia, Thailand, Kyrgyz Republic, Germany, Estonia, Croatia, China (Beijing) and the Russian Federation--have transitioned to using case-based payments, and especially diagnosis-related groups (DRGs), as part of their provider payment mix for hospital care. It sheds light on why particular technical design choices were made, what enabling investments were pertinent, and what broader political and institutional issues needed to be considered. The strategies used to phase in DRG payment receive special attention. These nine systems have been selected because they represent a variety of different approaches and experiences in DRG transition. They include the innovators who pioneered DRG payment systems (namely the United States and Australia), mature systems (such as Thailand, Germany, and Estonia), and countries where DRG payments were only introduced within the past decade (such as the Russian Federation and China). Each system is examined in detail as a separate case study, with a synthesis distilling the cross-cutting lessons learned. This book should be helpful to those working on health systems that are considering introducing, or are in the early stages of introducing, DRG-based payments into their provider payment mix. It will enhance the reader's understanding of how other countries (or systems) have made that transition, give a sense of the decisions that lie ahead, and offer options that can be considered. It will also be useful to those working in health systems that already include DRG payments in the payment mix but have not yet achieved the anticipated results.

EBOOK: Diagnosis-Related Groups in Europe: Moving towards transparency, efficiency and quality in hospitals

EBOOK: Diagnosis-Related Groups in Europe: Moving towards transparency, efficiency and quality in hospitals PDF Author: Reinhard Busse
Publisher: McGraw-Hill Education (UK)
ISBN: 0335245587
Category : Medical
Languages : en
Pages : 490

Book Description
Diagnosis Related Group (DRG) systems were introduced in Europe to increase the transparency of services provided by hospitals and to incentivise greater efficiency in the use of resources invested in acute hospitals. In many countries, these systems were also designed to contribute to improving – or at least protecting – the quality of care. After more than a decade of experience with using DRGs in Europe, this book considers whether the extensive use of DRGs has contributed towards achieving these objectives. Written by authors with extensive experience of these systems, this book is a product of the EuroDRG project and constitutes an important resource for health policy-makers and researchers from Europe and beyond. The book is intended to contribute to the emergence of a ‘common language’ that will facilitate communication between researchers and policy-makers interested in improving the functioning and resourcing of the acute hospital sector. The book includes: A clearly structured introduction to the main ‘building blocks’ of DRG systems An overview of key issues related to DRGs including their impact on efficiency, quality, unintended effects and technological innovation in health care 12 country chapters - Austria, England, Estonia, Finland, France, Germany, Ireland, the Netherlands, Poland, Portugal, Spain and Sweden Clearly structured and detailed information about the most important DRG system characteristics in each of these countries Useful insights for countries and regions in Europe and beyond interested in introducing, extending and/ or optimising DRG systems within the hospital sector

Care Without Coverage

Care Without Coverage PDF Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309083435
Category : Medical
Languages : en
Pages : 213

Book Description
Many Americans believe that people who lack health insurance somehow get the care they really need. Care Without Coverage examines the real consequences for adults who lack health insurance. The study presents findings in the areas of prevention and screening, cancer, chronic illness, hospital-based care, and general health status. The committee looked at the consequences of being uninsured for people suffering from cancer, diabetes, HIV infection and AIDS, heart and kidney disease, mental illness, traumatic injuries, and heart attacks. It focused on the roughly 30 million-one in seven-working-age Americans without health insurance. This group does not include the population over 65 that is covered by Medicare or the nearly 10 million children who are uninsured in this country. The main findings of the report are that working-age Americans without health insurance are more likely to receive too little medical care and receive it too late; be sicker and die sooner; and receive poorer care when they are in the hospital, even for acute situations like a motor vehicle crash.

Descriptive Statistics by Insurance Status for Most Frequent Hospital Diagnoses and Procedures

Descriptive Statistics by Insurance Status for Most Frequent Hospital Diagnoses and Procedures PDF Author:
Publisher:
ISBN:
Category : Health insurance
Languages : en
Pages : 134

Book Description


Diagnosis Related Groups (DRGs) and the Medicare Program

Diagnosis Related Groups (DRGs) and the Medicare Program PDF Author:
Publisher:
ISBN:
Category : Diagnosis
Languages : en
Pages : 100

Book Description


Definition of Serious and Complex Medical Conditions

Definition of Serious and Complex Medical Conditions PDF Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309172608
Category : Medical
Languages : en
Pages : 127

Book Description
In response to a request by the Health Care Financing Administration (HCFA), the Institute of Medicine proposed a study to examine definitions of serious or complex medical conditions and related issues. A seven-member committee was appointed to address these issues. Throughout the course of this study, the committee has been aware of the fact that the topic addressed by this report concerns one of the most critical issues confronting HCFA, health care plans and providers, and patients today. The Medicare+Choice regulations focus on the most vulnerable populations in need of medical care and other services-those with serious or complex medical conditions. Caring for these highly vulnerable populations poses a number of challenges. The committee believes, however, that the current state of clinical and research literature does not adequately address all of the challenges and issues relevant to the identification and care of these patients.

Improving Diagnosis in Health Care

Improving Diagnosis in Health Care PDF Author: National Academies of Sciences, Engineering, and Medicine
Publisher: National Academies Press
ISBN: 0309377722
Category : Medical
Languages : en
Pages : 473

Book Description
Getting the right diagnosis is a key aspect of health care - it provides an explanation of a patient's health problem and informs subsequent health care decisions. The diagnostic process is a complex, collaborative activity that involves clinical reasoning and information gathering to determine a patient's health problem. According to Improving Diagnosis in Health Care, diagnostic errors-inaccurate or delayed diagnoses-persist throughout all settings of care and continue to harm an unacceptable number of patients. It is likely that most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences. Diagnostic errors may cause harm to patients by preventing or delaying appropriate treatment, providing unnecessary or harmful treatment, or resulting in psychological or financial repercussions. The committee concluded that improving the diagnostic process is not only possible, but also represents a moral, professional, and public health imperative. Improving Diagnosis in Health Care, a continuation of the landmark Institute of Medicine reports To Err Is Human (2000) and Crossing the Quality Chasm (2001), finds that diagnosis-and, in particular, the occurrence of diagnostic errorsâ€"has been largely unappreciated in efforts to improve the quality and safety of health care. Without a dedicated focus on improving diagnosis, diagnostic errors will likely worsen as the delivery of health care and the diagnostic process continue to increase in complexity. Just as the diagnostic process is a collaborative activity, improving diagnosis will require collaboration and a widespread commitment to change among health care professionals, health care organizations, patients and their families, researchers, and policy makers. The recommendations of Improving Diagnosis in Health Care contribute to the growing momentum for change in this crucial area of health care quality and safety.