Distribution of critically ill patients (CIP) with severe sepsis (SS) according to the major diagnostic categories (MDC) of the diagnosis-related groups (DRG)

Abstract

Issue Title: ESICM LIVES 2015

Ruiz Moreno et al. Intensive Care Medicine Experimental 2015, 3(Suppl 1):A735

http://www.icm-experimental.com/content/3/S1/A735

POSTER PRESENTATION Open Access

Distribution of critically ill patients (CIP) with severe sepsis (SS) according to the major diagnostic categories (MDC) of the diagnosis-related groups (DRG)

J Ruiz Moreno1*, E Gonzlez Marn1, MJ Esteve Paos1, M Juli Amill1, N Surez lvarez1, M Moral Guiteras1, F Baigorri Gonzlez1, A Artigas Ravents2

From ESICM LIVES 2015Berlin, Germany. 3-7 October 2015

Introduction

Apart from financial purposes (cost accounting), DRG as case - mix system are not used for obtaining competitive advantage. MDC can be useful to classify the SS; if so, it is possible to assign each focus of sepsis to a specific category, which is important from a socio-economic perspective.

Objectives

Identify which MDCs encompasses a greater or lesser number of CIPs con SS. Find out which MDC incorporating CIPs with SS carries a higher an average relative weight (RW).

Methods

Type of Study: prospective, analytical, longitudinal, and observational Period: January 1-2011 / June 30-2014 (42 months)

Setting

Medical/Surgical ICU

Population: 2559 CIPs admitted consecutively to the ICU; sample: 484 CIPs. Exclusin criteria: CIPs < 16 y., major burn CIPs, incomplete clinical documentation, and voluntary discharge.

DRG AP-DRG 25.0 version (684 DRG are grouped into 25 MDC and 1 extra MDC). Depending on the focus of sepsis, SS related to MDC 0 (precategora) are transferred to another MDC. MDC: 1 (neurology), 2 (eye), 3 (ear, nose, mouth, throat), 4 (respiratory), 5 (circulatory), 6 (digestive, 7 (hepatobiliary & pancreas), 8 (musculoskeletal & connective), 9 (skin & breast), 10 (endocrine), 11 (urinary tract), 12 (male reproductive), 13 (female reproductive), 14 (pregnancy & childbirth), 15 (newborn), 16: (blood & immunological), 17 (mMyeloproliferative), 18 (infectious), 19 (mental), 20 (alcohol / drug), 21 (Injuries & poison), 22 (burns), 23 (factors influencing health status), 24 (HIV), 25 (PLT), 0 (Pre-Med, miscellany)

Results

See Tables 1, 2 and 3.

Excluded MDCs (< 8 DRG with SS): 2, 3, 4, 12,13, 14, 15, 16, 17, 19, 20, 21, 22, 23, 24 y 25

Conclusions

16 MDC do not identify SS (or less than 8 DRG). MDC 6, 4 and 7 carry more SS, that, it respectively, correspond to the septic focus abdominal, respiratory, and biliopancreatic. MDC 4 and 6 show the highest RW

1QuirnSalud Hospital Universitario Sagrat Cor, Critical Care Department, Barcelona, SpainFull list of author information is available at the end of the article

2015 Ruiz Moreno et al.; This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0

Web End =http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Ruiz Moreno et al. Intensive Care Medicine Experimental 2015, 3(Suppl 1):A735

http://www.icm-experimental.com/content/3/S1/A735

Page 2 of 2

Table 1 Results I

Global % SS % no SS % p value CIPs 2559 100 484 18,8 2075 81,1Age 65,9 73,5 64,1 0,001 Mortality 159 6,21 119 24,6 63 3,0 0,001 RW 4,21 7,9 3,35 0,001

Table 2. Results II

MDC SS % average RW 1 8 1,7 8,45984 114 24,0 11,06775 30 6,3 6,19616 152 32,0 9,93827 94 19,8 4,5068

Table 3. Results III

MDC SS % average RW 8 14 2,9 5,11919 8 1,7 4,032011 22 4,6 5,168718 33 6,9 3,7598 Global 475 100 7,9815

Authors details

1QuirnSalud Hospital Universitario Sagrat Cor, Critical Care Department, Barcelona, Spain. 2Hospital de Sabadell & QuirnSalud Hospital Universitario Sagrat Cor, Critical Care Department, Sabadell, Spain.

Published: 1 October 2015

References1. Busse r, Geissler A, Quentin W, Wiley M: Diagnosis-Related Groups in Europe. Moving towards transparency, efficiency and quality in hospitals Open Univy Press McGraw-Hill Education, England; 2011, European Observatory onHealth Systems and Policies.

2. Homburg K, Rst CA, Fodor P, Blumenthal S: Do Diagnosis Related Groups change admission practice to a large Swiss ICU? Critical Care 2013, 17(Suppl 2):484.

doi:10.1186/2197-425X-3-S1-A735Cite this article as: Ruiz Moreno et al.: Distribution of critically ill patients (CIP) with severe sepsis (SS) according to the major diagnostic categories (MDC) of the diagnosis-related groups (DRG). Intensive Care Medicine Experimental 2015 3(Suppl 1):A735.

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