A psychiatric patient classification system. An alternative to diagnosis-related groups

Medical Care
M L AshcraftP Errera

Abstract

It is generally accepted that diagnosis-related groups (DRGs) for alcohol, drug, and mental disorders are inappropriate for inpatient prospective payment. To address this issue, the Veterans Administration (VA) supported a project to construct alternative classes that are more clinically meaningful, more homogeneous in their resource use, and that account for more variation in resource use among psychiatric and substance use cases than existing DRGs. This paper reports on this project. Using a data set containing universally available discharge data plus behavioral, social, and functional information obtained by a survey of 116,191 discharges from VA psychiatric beds, and with AUTOGRP as the classifying algorithm, a classification system was formed. Twelve psychiatric diagnostic groupings (PDGs) were identified, analogous to major diagnostic groups in the DRG system. Within each PDG, from 4 to 9 terminal groups of Psychiatric Patient Classes (PPCs) were formed and validated. The 12 substance abuse PPCs explain greater than 31% of the variation in length of stay; for the mental disorder PPCs the variance explanation is greater than 11%, a substantial improvement over DRGs that, for the same data set, explain less than 2 and 3%, ...Continue Reading

Citations

Oct 7, 2010·Administration and Policy in Mental Health·Alex D TullochAnthony S David
Mar 31, 2010·Behavioral Sleep Medicine·Kathleen A FoleyJames K Walsh
Feb 5, 2013·ClinicoEconomics and Outcomes Research : CEOR·Anagha NadkarniTony Hebden
Dec 17, 2014·Journal of Therapeutic Ultrasound·Bijan J BorahElizabeth A Stewart
Aug 9, 2008·Journal of Women's Health·Ginger Smith CarlsElizabeth Stewart
Dec 29, 2010·Journal of Occupational and Environmental Medicine·Stephen S JohnstonRoss Maclean
Feb 13, 2016·Population Health Management·Shirley MusichAndrea Klemes
Jun 3, 2010·Current Medical Research and Opinion·Carl V AscheChristopher L Drake
Mar 28, 2008·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Robert H DworkinKevin Hawkins
Sep 9, 2008·European Psychiatry : the Journal of the Association of European Psychiatrists·Sylke AndreasHolger Schulz
Jul 31, 2007·Journal of the American Geriatrics Society·Robert H DworkinKevin Hawkins
Dec 12, 2007·Headache·Kevin HawkinsMarcia Rupnow
Oct 9, 2015·The European Journal of Health Economics : HEPAC : Health Economics in Prevention and Care·Mark Pletscher
Jan 7, 2015·American Journal of Health Promotion : AJHP·Shirley MusichKevin Hawkins
Mar 1, 1994·The Australian and New Zealand Journal of Psychiatry·C E Hunter, A C McFarlane
Apr 3, 2014·Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery·Meena SeshamaniDennis Scanlon
Mar 16, 2017·Psychiatry and Clinical Neurosciences·Daisuke ShinjoKiyohide Fushimi
Dec 1, 1995·Archives of Physical Medicine and Rehabilitation·M G Stineman
Jan 1, 1999·International Journal of Psychiatry in Clinical Practice·M TregliaR L Dunn
Jan 26, 2018·Journal of Occupational and Environmental Medicine·Rachel M HenkeRon Z Goetzel
Mar 5, 2015·The American Journal of Hospice & Palliative Care·Shirley MusichCharlotte S Yeh
Apr 28, 2007·Australasian Psychiatry : Bulletin of Royal Australian and New Zealand College of Psychiatrists·Graham MellsopSelim El-Badri
Jul 19, 2018·PharmacoEconomics·Kristina R DahlstromDavid R Lairson
Feb 1, 2013·Journal of Nursing Measurement·Caitlin W BrennanJeffrey Van Der Meulen
Nov 14, 2006·Journal of Occupational and Environmental Medicine·Ronald J OzminkowskiDee W Edington
May 15, 2007·Journal of Occupational and Environmental Medicine·David W LeeElizabeth A Stewart
May 1, 2010·Journal of Occupational and Environmental Medicine·Rachel M HenkeRon Z Goetzel
Apr 12, 2007·Journal of Occupational and Environmental Medicine·Kevin HawkinsMarcia F T Rupnow
Apr 25, 2007·Harvard Review of Psychiatry·Richard C HermannJeffrey A Chan
Mar 17, 2011·Journal of the American Podiatric Medical Association·Ginger S CarlsJames R Christina
Mar 26, 2019·Journal of Lower Genital Tract Disease·Shuangshuang FuDavid R Lairson
Nov 26, 2019·Population Health Management·Shirley MusichCharlotte S Yeh

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