Clinical trial NCT04726202: Impact of Semi-automated Proposal and Optimization of Diagnoses and Surgical Procedures for Precoding: a Randomized Controlled Trial
Official title: Impact of Semi-automated Proposal and Optimization of Diagnoses and Surgical Procedures for Precoding: a Randomized Controlled Trial
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Diagnosis-Related Groups
Healthcare Common Procedure Coding System
Keywords: DRG
Diagnosis-Related Groups
ICD
reimbursement
Lead sponsor: Cantonal Hospital of St. Gallen
Sponsor class: OTHER
First posted: 2021-01-27
Enrollment: 1200
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: CASE_CONTROL
Time perspective: PROSPECTIVE
Sampling method: PROBABILITY_SAMPLE
Study population: patients undergoing inpatient surgery in the fields of General, Visceral, Endocrine or Transplantation Surgery

Brief summary: The hypothesis of present study is that the daily monitoring and optimization of DRG coding is associated with higher reimbursement. Therefore, the primary objective is to determine if the daily monitoring and optimization of DRG coding of individual cases leads to better proceeds per day.


Eligibility criteria: Inclusion Criteria:

* patients undergoing surgery as inpatients (at least one night stay)
* treated at the Kantonsspital St. Gallen, St. Gallen site

Exclusion Criteria:

* surgery as outpatients
* surgery at the Rorschach and Flawil sites
* patients operated on by the Department of Surgery, but hospitalized at another department of the hospital

Primary outcomes:
measure: reimbursement per day at hospital
timeFrame: 8 months
Secondary outcomes:
measure: Length of hospital stay
timeFrame: 8 months
measure: Total reimbursement per case
timeFrame: 8 months
measure: case mix index per case
timeFrame: 8 months
measure: Severity of perioperative complications
timeFrame: 8 months
measure: readmission rate
timeFrame: 8 months
Other outcomes:
Locations:
city: St. Gallen
country: Switzerland
facility: Department of Surgery, Cantonal Hospital of St. Gallen
Study officials:
affiliation: Cantonal Hospital St. Gallen
name: Thomas Steffen, MD
role: PRINCIPAL_INVESTIGATOR
References:
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citation: Hughes JS, Lichtenstein J, Fetter RB. Procedure codes: potential modifiers of diagnosis-related groups. Health Care Financ Rev. 1990 Fall;12(1):39-46.
citation: Geuss S, Jungmeister A, Baumgart A, Seelos R, Ockert S. [Prospective DRG coding : Improvement in cost-effectiveness and documentation quality of in-patient hospital care]. Chirurg. 2018 Feb;89(2):138-145. doi: 10.1007/s00104-017-0555-4. German.
citation: Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004 Aug;240(2):205-13. doi: 10.1097/01.sla.0000133083.54934.ae.
citation: Clavien PA, Barkun J, de Oliveira ML, Vauthey JN, Dindo D, Schulick RD, de Santibanes E, Pekolj J, Slankamenac K, Bassi C, Graf R, Vonlanthen R, Padbury R, Cameron JL, Makuuchi M. The Clavien-Dindo classification of surgical complications: five-year experience. Ann Surg. 2009 Aug;250(2):187-96. doi: 10.1097/SLA.0b013e3181b13ca2.