Whyte G S, Brook C W
Australian Red Cross Blood Service, Melbourne, VIC.
Med J Aust. 1998 Oct 19;169(8):415-8.
To study the suitability of diagnosis-related groups (DRGs) to quantify blood use in order to fund hospitals directly for fresh blood components.
(i) Retrospective empirical analysis of hospital inpatient separation data, matching DRG classification with blood usage. (ii) Prediction of blood usage based on actual DRGs and comparison with actual blood products issued from the blood service.
Eight large public hospitals, April 1994-March 1995, the Department of Human Services and the Australian Red Cross Blood Service in Victoria, 1994-1997.
Requirement for transfusion according to DRG; quantity of blood or blood products transfused; and statistical reliability of measuring blood component usage by DRG.
A match between patient records and transfusion records for 287,117 patient separations showed that the patients had received 51,115 units of red cells, 30,451 units of platelet concentrates, 9043 units of fresh frozen plasma and 1273 units of cryoprecipitate. Ten per cent of DRGs (527) accounted for over 70% of blood product usage. The numbers of DRGs in which blood products were used for at least 30 separations (with a relative SEM [for units of blood used per separations using blood] of up to 20% at a 95% confidence level) were 56 for red cells, 8 for platelets and 4 for fresh frozen plasma. Estimates of red cell usage calculated from actual DRGs for three consecutive years (1994-1997) showed that DRGs predicted aggregate issues of red cells by the Red Cross Blood Service (ratio of actual red cells issued to red cell usage estimates were 1.036 for 1994-95, 0.994 for 1995-96, and 1.021 for 1996-97, respectively).
DRGs are moderately good predictors of blood product usage, and could be used to allocate funds for blood products to hospitals instead of to the blood service. However, DRG data are not designed to manage blood issue policies, because DRGs do not represent single diagnoses or procedures and some are surrogate descriptions of procedures.
研究诊断相关分组（DRGs）用于量化用血情况的适用性，以便直接为医院提供新鲜血液成分的资金。
（i）对医院住院患者分离数据进行回顾性实证分析，将DRG分类与用血情况相匹配。（ii）基于实际DRGs预测用血情况，并与血液服务机构实际发放的血液制品进行比较。
八家大型公立医院，1994年4月至1995年3月；维多利亚州人类服务部和澳大利亚红十字会血液服务机构，1994 - 1997年。
根据DRG的输血需求；输注的血液或血液制品数量；以及通过DRG衡量血液成分使用情况的统计可靠性。
对287,117例患者分离的患者记录与输血记录进行匹配，结果显示患者共接受了51,115单位红细胞、30,451单位浓缩血小板、9043单位新鲜冰冻血浆和1273单位冷沉淀。10%的DRGs（527个）占血液制品使用量的70%以上。血液制品用于至少30例分离的DRGs数量（在95%置信水平下，每例用血单位的相对标准误[SEM]高达20%），红细胞为56个，血小板为8个，新鲜冰冻血浆为4个。连续三年（1994 - 1997年）根据实际DRGs计算的红细胞使用量估计值表明，DRGs预测了红十字会血液服务机构的红细胞总发放量（1994 - 95年实际发放的红细胞与红细胞使用量估计值的比率为1.036，1995 - 96年为0.994，1996 - 97年为1.021）。
DRGs对血液制品使用情况的预测能力中等，可以用于向医院而非血液服务机构分配血液制品资金。然而，DRG数据并非用于管理血液发放政策，因为DRGs并不代表单一诊断或程序，有些是程序的替代描述。
