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analysis was clearly explained. This booklet would be useful in solving arguments where definitions or statisti useful for anyone interested in this subject. cal formulas are unclear. Maureen Robinson Nola Borneman Victoria Victoria Title: Data Quality and DRGs Author: Finnegan, R. Title: Glossary of Health Care Terms Publisher and Distributor: American Medical Record Editor: Glondys, B. Association (AMRA), Suite 1850, 875 North Michigan Publisher and Distributor: American Medical Record Avenue, Chicago, Illinois 60611, USA. Association, Suite 1850, 875 North Michigan Avenue, Chicago, Illinois 60611, USA Diagnosis Related Groups, or DRGs, is a subject with which all MRAs should now be familiar. We know that, in This glossary was published in 1986 and is the seventh order for a hospital to be represented correctly and ade edition since 1969.It is a reference guide to standardised quately in analyses of DRGs, and weighted indices, it is health care terminology, definitions and uniform statis necessary for coding and data collection to be of the tical computations. highest possible standard. The book recognises that terms can have various mean This book looks at ways of ensuring the quality of data ings and definitions, depending on who or what they are collected, and explains how this data is converted into being used for, and so attempts to clarify some problem DRGs. areas of statistical data collection and interpretation. The American Medical Record Association believes This has been accomplished by providing definitions seven characteristics of data are essential to ensure of certain terms, with notes about how the terms are quality: reliability, validity, completeness, timeliness, currently used and the implications of different inter accessibility, confidentiality and security. pretations. The importance of accurate coding is stressed. Ac The glossary takes the form of ten chapters. The first curate coding includes checking that all relevant con two begin by giving definitions of such fundamental ditions are coded fully, and that the codes are sequenced terms as Medical, Service, Care and Hospital. Hospital correctly, as well as making sure that all coders are fully Patients and Hospital Patient Data are the subjects of trained and conversant with ICD-9-CM. the next two chapters, with much detail spent defining Many examples of quality assurance exercises and diagnosis, both Principal and Other diagnoses. tests to ensure data quality are given. Chapter 5 deals with Facilities and Units and Chapter The book focuses on helping medical record adminis 6 with Events and other units of measure. It is this area trators improve data quality and understand DRGs. where definitions are given of Admission, Discharge, Extensive definitions of DRGs and Major Diagnostic Transfer, Occasion of Service, Procedure and many Categories (MDCs) are given. These explain what a more. DRG is and the information used to allocate a case to a Obstetric and Perinatal terminology is also included. particular DRG. The definitions include explanations of Definitions requiring a measurement of gestational age what data, other than ICD-9-CM codes, are used and or birthweight, such as Preterm Infant, are the same as why, and what constitutes an 'Outlier'. those recorded in ICD-9-CM. Statistical tabulations for Section 3 deals with management reporting. While various Obstetric and Perinatal rates are well docu DRGs are being used in the USA for payment to hos mented. pitals, they can also be useful to the hospital by facilitat Chapter 8 relates to Ambulatory Care, Hospice and ing more analytical use of medical record data. The Home Care and includes Outpatient Care Units and analyses described in this section fall into two cate Emergency Services. gories: management of the hospital and patient care. A sample Uniform Ambulatory Medical Care minimum Examples of uses for management include financial plan data set forms part of this chapter which could be rele ning, resource allocation and planning and marketing of vant to Community Health Centres as well as large medi services. Other uses for patient care are mainly quality cal clinics. assurance, utilisation review and risk management acti The final chapters are concerned with statistical terms vities. Examples of some reports from hospitals are and principles: Rates, Ratios, Proportions, Percentages included as guidelines. and Hospital Statistics - Measurements and Indicators. A series of self-assessment exercises are given in Sec This includes census data, length of stay and aggrega tion 4. These are very interesting and cover such topics tion of bed days. Also looked at are some of the pitfalls as an analysis of hospital inpatient service, a review of and problems of producing statistics which can accurately coding principles, sequencing of diagnoses and pro reflect the activity in a hospital, as well as being compar cedures and the assignment of DRGs. The answers are able between hospitals. also included to check your results. The book deals with the basics of any statistical ana Over half the book is taken up with Appendices. The lyses, which do not vary between countries or states, so first of these is a Data Needs Assessment and is only would make a valuable reference tool. It may even be relevant to American readers. 174 AMR JOURNAL, DECEMBER, 1988
Australian Medical Record Journal – SAGE
Published: Dec 1, 1988
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