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UID:822@nordcaseforum.easyredmine.com
DTSTART:20220315T000000
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CREATED:20220315T103605
DESCRIPTION:Mats Fernström\, the National Board of Health and Welfare\, Sw
 eden 2022-02-23 (SWE ID C927) This is a reminder that we still want a deve
 lopment in the direction that we outlined in case #545 but we have created
  this new case since #545 is closed (see Kristiinas comment 10-8-2021). Ou
 r wishes are repeated below in short. There might be further wishes from o
 ther countries as well. The matter must be discussed by the Expert group (
 a smaller working group first?) and eventually decided by the Board\, sinc
 e the changes mean changes in the program code for all groupers\, which in
  turn will cause some costs. With this in mind\, it may be a good idea to 
 implement the changes at the same time as ICD-11 is implemented\, as the p
 rogram code in the groupers then must be updated anyhow.  In the grouping 
 rules (table drg_logic) there is a terrible mess with type of care (e.g. p
 rimary care)\, type of contact and type of profession in the fields for di
 agnoses and procedures. In addition\, procedures are specified in the fiel
 ds for diagnoses (via dgprop). Instead\, the rules should have separate fi
 elds for administrative parameters like type of care\, contact and profess
 ion and there should be more fields for procedures so it is possible to co
 nstruct rules based on more than two procedures without using dgprop. Ther
 e should also be fields for the patient’s functionality or for severity 
 of illness and other factors that can be of interest to include in the gro
 uping logic in the future. Furthermore\, we should discuss if there should
  be a marker on certain rules that tells the grouper that the demands in t
 he dgprop fields are of the type “AnyOf” (now it is always “AllOf”
 ). Then\, for example\, the 32 rules for DRG Q55N ’Nyfödd\, födelsevik
 t 2500 g eller mer\, med annat signifikant problem’ (= DRG 390X ‘Neona
 te\, birthweight 2500 g or more\, with other significant problem’) could
  be replaced by only 2 rules. (However\, such a change has a rather limite
 d ability to reduce the total number of rules\, I think\, so it may be not
  worth the effort.)  A possibility to have multiple coding for procedures 
 (similar to asterisk-dagger for diagnoses) so that general qualifiers (NCS
 P codes beginning with Z) are hooked to the right intervention code is imp
 ortant\, however. With the present logic\, an irrelevant bilateral procedu
 re (e.g. peripheral intravenous catheters) can lead to a DRG for major bil
 ateral interventions (e.g. DRG 471N ‘Bilateral or multiple major joint p
 rocs of extremities’).  The question about if two or more diagnoses with
  CC property should generate MCC property in case #818 can be added to the
 se development discussions.  When ICD-11 is implemented in NordDRG\, we al
 l have to cope with new codes and then\, at the same time\, it could be ap
 propriate to introduce systematic DRG codes that are common for all countr
 ies. It could be similar to the present Swedish codes but with more charac
 ters.
LAST-MODIFIED:20250904T054432
ORGANIZER:mailto:mats.fernstrom@socialstyrelsen.se
PRIORITY:5
SEQUENCE:0
STATUS:CONFIRMED
SUMMARY:Further development of NordDRG
URL;VALUE=URI:https://nordcaseforum.easyredmine.com/issues/822
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