A Study Using Working DRGs to Examine Variations in Length of Stay

Abstract

The results of a working DRG utilisation review study conducted at St Vincent's Hospital, Sydney in 1992 are described. The project aimed to allocate a working DRG to Cardiology and Orthopaedic patients. Working DRGs are defined as DRGs allocated on admission based on the presenting problem or provisional diagnosis.

Patients were then concurrently reviewed until discharge. Actual length of stay (LOS) of patients was compared to the LOS predicted by the working DRG.

Results indicated that a utilisation review program using a working DRG can predict a LOS reasonably well for large groups of patients but not for individual patients and that St Vincent's is a comparatively efficient provider of Cardiology and Orthopaedic Services. The paper describes the study design, methods and results.

Medical Record Managers played an integral role in the preparation phase, design of the study, day to day coordination and analysis of results. Medical Record Managers' participation in the study is highlighted in this paper.

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References

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(1993) The Quality of Clinical Documentation and Subsequent Effect on DRG Assignment. St Vincent's Hospital, Sydney.

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(1992). Allocating a working DRG: a new tool for hospital management Unpublished.