The Effect of Comorbidity and Complication on the Explanation of the Taiwan Diagnosis Related Groups-An Example of Disease and Disorder of the Respiratory System

• Main Authors: Tseng-Hui Chen, 曾卉珍
• Other Authors: Chun-Hung Hsu
• Format: Others
• Language: zh-TW
• Online Access: http://ndltd.ncl.edu.tw/handle/yzdpkv

碩士 === 元培醫事科技大學 === 醫務管理研究所 === 103 === Background: Tw-DRGs past research indicates that there is a difference on the impact of the hospital, the highlight fairness and ill Tw-DRGs medical resources of the medical treatment of the topic can be near. Objectives: This study investigated the 2008 Medicare definition of major complications Severity DRGs (MS-DRGs) / complications (Major Complication or Comorbidity, MCC), the feasibility of Tw-DRGs as a basis for classification, the period Tw-DRGs in line with the principle of fair and reasonable payment. Research methods: The study was cross-sectional study in 2008 to 2012, the study for the National Health Insurance Research Database in cases of respiratory diseases. An analysis of the 2010 implemented Tw-DRGs reimbursement system was conducted to compare it to the MS-DRGs system in use at USA. We calculated the number of additional diagnoses, the number of procedures volume per admission and average length of stay…etc. we carried out the chi-square analysis, correlation, One-Way ANOVA and linear regression. Results: Analysis and comparison of changes in the amount of MCC have two groups with and without MCC degree of medical resources consumed. The numbers of CC were dramatic increasely from 0.87 at 2008 to 0.96 in 2012 (F=405.67, p<0 .001) during the before-after implemented Tw-DRGs. Also, from the view point of numbers of additional diagnoses, the result (2.56 vs 2.71, F=719.69, p< 0.001) was almost same with the CC. Linear regression was shown that the R2 =0 .440 in Tw-DRGs, and 0.347 in MS-DRGs. Conclusions: The numbers of CC, numbers of additional diagnoses were dramatic increasely during the before-after implemented Tw-DRGs. Through the linear regression was shown that the R2 in Tw-DRGs more slight than MS-DRGs.