Date: Thu, 7 Apr 2005 13:48:05 -0400
Reply-To: "Michael S. Zdeb" <msz03@HEALTH.STATE.NY.US>
Sender: "SAS(r) Discussion" <SAS-L@LISTSERV.UGA.EDU>
From: "Michael S. Zdeb" <msz03@HEALTH.STATE.NY.US>
Subject: Re: Stat Opinion Question
Content-type: text/plain; charset=US-ASCII
Hi...there are a couple instances where a similar problem has been
addressed...it's not a direct answer to just having a list of ICD codes and
saying what should end up as #1, but the simplified answer is meant to show
that it's not easy (as has been mentioned by other responders).
#1 DRGs (or why are you in the hospital) - multiple conditions get reduced
to a single 3-digit number that 'describe' your hospital stay. It's
usually related to the principal diagnosis (PDX), but not always. For
example, in NY, a woman delivering a baby would normally have a PDX and DRG
that both indicate that the main reason for the stay was the delivery.
However, if there are problems and the woman has a tracheostomy, the PDX
would still indicate a delivery, but for the DRG, the tracheostomy tops the
delivery. Why? DRGs are linked to reimbursment and the tracheostomy DRG
returns more money.
#2 Cause of Death (why did you die) - a lot of info is written on a death
certificate and each condition ends up with an ICD code on a multiple cause
file. However, there is a hierarchy and one cause ends up as underlying.
The 'rules' are implemented via software from the National Center for
Health Statististics.
http://www.cdc.gov/nchs/about/major/dvs/about.htm
There has been a discussion of acronyms, how about ACME...Automated
Classification of Medical Entities...
ACME Automates the underlying cause-of-death coding rules. The input to
ACME is the multiple cause-of-death codes (ICD) assigned to each entity
(e.g., disease condition, accident, or injury) listed on cause-of-death
certifications, preserving the location and order as reported by the
certifier. ACME then applies the World Health Organization (WHO) rules to
the ICD codes and selects an underlying cause of death.
Mike Zdeb
U@Albany School of Public Health
1 University Drive
Rensselaer, NY 12144-3456
(P)518-402-6479
(F)630-604-1475
|---------+--------------------------------->
| | "Worden, Nina" |
| | <nina.worden@SUMMITMAR|
| | KETING.COM> |
| | Sent by: "SAS(r) |
| | Discussion" |
| | <SAS-L@LISTSERV.UGA.ED|
| | U> |
| | |
| | |
| | 04/07/2005 12:24 PM |
| | Please respond to |
| | "Worden, Nina" |
| | |
|---------+--------------------------------->
>----------------------------------------------------------------------------------------------------------------------|
| |
| To: SAS-L@LISTSERV.UGA.EDU |
| cc: |
| Subject: Stat Opinion Question |
>----------------------------------------------------------------------------------------------------------------------|
If you have a patient that has numerous conditions and you want to put
them in a group that represents the primary condition that's effecting
their health, how do you go about making that determination? What
tool/process/method would you apply to the data? I realize this is an
opinion question and will most likely receive various answers which is
OK considering I'm looking for ideas.
Nina
