Hughes J S, Lichtenstein J, Fetter R B
Yale-New Haven Hospital, CT 06504.
Health Care Financ Rev. 1990 Fall;12(1):39-46.
Proposals to make complexity-of-illness adjustments to the diagnosis-related group system have relied on secondary diagnosis codes and additional clinical information obtained from the hospital record. Another potential mechanism for modifying diagnosis-related groups involves the use of non-operating room procedure codes. The use of these codes has the advantage of reliably identifying costly subgroups of patients and thus the potential to provide for fairer compensation to hospitals caring for the sickest patients. There are a number of disadvantages, however, and therefore the criteria with which to evaluate procedures as potential modifiers are suggested.
对诊断相关分组系统进行疾病复杂性调整的提议，依赖于二级诊断代码以及从医院记录中获取的其他临床信息。修改诊断相关分组的另一种潜在机制涉及使用非手术室程序代码。使用这些代码的优点是能够可靠地识别成本较高的患者亚组，从而有可能为照料病情最严重患者的医院提供更公平的补偿。然而，也存在一些缺点，因此提出了将程序评估为潜在调整因素的标准。
