Diagnosis-Related Groups Clinical Trial
Official title:
Impact of Semi-automated Proposal and Optimization of Diagnoses and Surgical Procedures for Precoding: a Randomized Controlled Trial
| NCT number | NCT04726202 |
| Other study ID # | Chir201902 |
| Secondary ID | |
| Status | Completed |
| Phase | |
| First received | |
| Last updated | |
| Start date | June 1, 2019 |
| Est. completion date | January 31, 2020 |
| Verified date | August 2021 |
| Source | Cantonal Hospital of St. Gallen |
| Contact | n/a |
| Is FDA regulated | No |
| Health authority | |
| Study type | Observational |
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.
| Status | Completed |
| Enrollment | 1200 |
| Est. completion date | January 31, 2020 |
| Est. primary completion date | January 1, 2020 |
| Accepts healthy volunteers | No |
| Gender | All |
| Age group | 18 Years and older |
| Eligibility | Inclusion Criteria: - patients undergoing surgery as inpatients (at least one night stay) - treated at the Kantonsspital St. Gallen, St. Gallen site Exclusion Criteria: - surgery as outpatients - surgery at the Rorschach and Flawil sites - patients operated on by the Department of Surgery, but hospitalized at another department of the hospital |
| Country | Name | City | State |
|---|---|---|---|
| Switzerland | Department of Surgery, Cantonal Hospital of St. Gallen | St. Gallen |
| Lead Sponsor | Collaborator |
|---|---|
| Thomas Steffen |
Switzerland,
Clavien PA, Barkun J, de Oliveira ML, Vauthey JN, Dindo D, Schulick RD, de Santibañes 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. — View Citation
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. — View Citation
Fetter RB, Freeman JL. Diagnosis related groups: product line management within hospitals. Acad Manage Rev. 1986 Jan;11(1):41-54. — View Citation
Fetter RB. Hospital payment based on diagnosis-related groups. J Soc Health Syst. 1992;3(4):4-15. — View Citation
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. Review. — View Citation
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. — View Citation
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. — View Citation
Hughes JS, Lichtenstein J, Fetter RB. Procedure codes: potential modifiers of diagnosis-related groups. Health Care Financ Rev. 1990 Fall;12(1):39-46. — View Citation
| Type | Measure | Description | Time frame | Safety issue |
|---|---|---|---|---|
| Primary | reimbursement per day at hospital | total reimbursement per arm divided by the total stay of the patients in the arm in days | 8 months | |
| Secondary | Length of hospital stay | length of hopital stay in full days including entry and discharge day | 8 months | |
| Secondary | Total reimbursement per case | reimbursement in Swiss Francs per case | 8 months | |
| Secondary | case mix index per case | Financial department will provide the cost weight/case mix index per case | 8 months | |
| Secondary | 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 | |
| Secondary | readmission rate | Rate of case related readmissions | 8 months |