Posts tagged: Admissions

drg effects on hospital admissions

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By , July 11, 2015 11:56 pm
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  • drg effects on hospital admissions

    https://oig.hhs.gov/oei/reports/oei-09-00-00200.pdf
    Medicare Hospital Prospective Payment System: How DRG Rates …
    In this DRG prospective payment system, Medicare pays hospitals a flat rate per
    case for inpatient … technology, inflation, and other factors that affect the cost of
    providing care;. 3. … 3. the appropriateness of admissions and discharges; and.

    http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/AcutePaymtSysfctsht.pdf
    Acute Care Hospital Inpatient Prospective Payment System (IPPS)
    diagnostic services and admission-related outpatient nondiagnostic services …
    Other factors that may influence DRG assignment include a beneficiary's gender
     …

    http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/HospitalAcqCond/Downloads/HAC-SpilloverEffects.pdf
    Hospital-Acquired Conditions–Present on Admission: Examination …
    Sep 1, 2012 … Hospital-Acquired Conditions–Present on Admission: Examination of … Section 3
    Spillover Effects of the HAC-POA Program to Other Payers . ….. would no longer
    pay a higher DRG rate if the conditions occurred in the …

    http://www.princeton.edu/~ota/disk3/1983/8306/830608.PDF
    Diagnosis Related Groups (DRGs) and the Medicare Program …
    oped as a method for characterizing hospitals' case … about the effect of DRG
    payment on the adop- …. dates a study of its impact on hospital admissions.

    http://www.homepages.ucl.ac.uk/~uctpimr/research/health.pdf
    Policing Cannabis and Drug Related Hospital Admissions: Evidence …
    All such policies aim to curb both drug use and its negative consequences, ….
    policy had significant long term impacts on hospital admissions in Lambeth
    related …

    http://www.aha.org/research/reports/tw/12dec-tw-ptacuity.pdf
    Are Medicare Patients Getting Sicker? – American Hospital Association
    the effect of changes in how hospitals … Medicare Severity-adjusted Diagnosis
    Related Groups (MS-DRGs) Coding … require admission to the intensive.

    http://www.medicine.ox.ac.uk/bandolier/extraforbando/adrpm.pdf
    Adverse drug reactions in hospital patients – Medical Sciences …
    1 To estimate incidence of ADRs causing hospital admission or occurring whilst
    in hospital in the UK …. drug and related to dose and pharmacological effect,.

    http://www.biomedcentral.com/content/pdf/1472-6963-11-134.pdf
    Drug-related admissions and hospital-acquired … – BioMed Central
    May 29, 2011 … Results: Among all hospital admissions, 5% were found to be at least possibly …..
    Unspecified adverse effect of drug or medicament. A.2. 5004.

    https://www.medicare.gov/Pubs/pdf/11435.pdf
    Are You a Hospital Inpatient or Outpatient? – Medicare.gov
    considers you an “inpatient” or “outpatient”) affects how much you pay for hospital
    … The decision for inpatient hospital admission is a complex medical decision …
    If you have Medicare prescription drug coverage (Part D), these drugs may be.

    http://content.healthaffairs.org/content/8/2/35.full.pdf
    hospital case-mix change: sicker patients or drg creep? – Health Affairs
    ceived much attention is the effect of PPS on hospitals' case-mix (the mix of
    patients …. mined after study to be chiefly responsible for the hospital admission.

    http://www.nber.org/chapters/c7322.pdf
    Medicare Reimbursement and Hospital Cost Growth – National …
    As a result, a hospital admission per se does not consti- …. managers can
    significantly influence admissions in these DRGs. Regardless of the nature of
    medical …

    http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.128.1331&rep=rep1&type=pdf
    Drug-related problems in elderly patients admitted to … – CiteSeer
    Introduction: although drug-related problems (DRPs) are known to be prevalent
    in elderly patients, the literature on prevention … and are responsible for hospital
    admission [5-7]. half the …. To assess the effects of the intervention strategies on.

    http://eurodrg.projects.tu-berlin.de/publications/DRGbook/Ch7_Street.pdf
    DRG-based hospital payment and efficiency: Theory … – EuroDRG
    Since then, DRG-based hospital payment has been widely adopted ….. imply
    different hypotheses about the impact of DRG-based payment; that is, …..
    admissions increased in Australia (Ettelt et al., 2006; Street et al., 2007),
    Denmark.

    http://www.pharmacy.arizona.edu/sites/default/files/pdfs/Horn-FINAL.pdf
    Drug Interactions Related to Hospital Admissions
    To identify all possible drug interactions … effects on warfarin AUC or Cmax . But
    … Hospital. Total MAJORs in. Database. DIs Reduced in. Severity (%). UWMC.

    https://secure.cihi.ca/free_products/Hospitalizations%20for%20ADR-ENweb.pdf
    Adverse Drug Reaction–Related Hospitalizations Among … – CIHI
    (WHO) as adverse effects of a drug that was properly administered in the …
    estimated to account for up to two-thirds of drug-related hospital admissions and
    ED …

    http://www.hca.wa.gov/medicaid/billing/documents/guides/inpatient_hospital_mpg.pdf
    Inpatient Hospital Services Provider Guide – Health Care Authority
    Apr 1, 2015 … This publication takes effect April 1, 2015, and supersedes earlier …. Diagnosis
    related group (DRG) payment method (Inpatient primary ….. Out-of-state hospital
    admissions (does not include hospitals in designated bordering.

    http://www.justice.gov/atr/public/eag/221240.pdf
    Patient Admission Patterns and Acquisitions of "Feeder" Hospitals
    When acquisitions did lead to increased referrals, the effect …. (CMS) attempts to
    set DRG payments near the mean cost of treating each … conclude that hospitals
    do attempt to discourage admissions of unprofitable patients by lowering.

    https://openknowledge.worldbank.org/bitstream/handle/10986/4186/WPS4987.pdf?sequence=1
    System-Wide Impacts of Hospital Payment Reforms – World Bank …
    paying hospitals through the use of diagnosis-related groups (DRGs) and
    subsequent … Kroneman and Nagy (2001) look at the effects on hospital
    admissions, …

    http://www.medpac.gov/documents/january-2015-meeting-presentation-hospital-short-stay-policy-issues.pdf?sfvrsn=0
    MedPAC Presentation – Hospital Short Stay Policy Issues
    Jan 16, 2015 … Recap: Hospital short stay issues. ▫ Inpatient admission criteria are ambiguous
    and open … Effect of simulated 1-day stay DRG policy.

    http://www.isdbweb.org/documents/file/1486_4.pdf
    The Effects of Polypharmacy in Older Adults – ISDB
    The tables present important relevant studies relating to the effects of different …
    for increased drug use in old age.6 Hospital admissions related to. ADRs have …

    drg on hospital admissions and the length of stay

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    By , December 18, 2014 12:43 pm
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  • drg on hospital admissions and the length of stay

    https://oig.hhs.gov/oei/reports/oei-09-00-00200.pdf
    Medicare Hospital Prospective Payment System: How DRG Rates …
    In this DRG prospective payment system, Medicare pays hospitals a flat rate per
    case for inpatient hospital ….. lengths of stay or costs exceed the threshold rate.

    http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/AcutePaymtSysfctsht.pdf
    Acute Care Hospital Inpatient Prospective Payment System (IPPS)
    admission. In addition … Similarly, DRG assignment can be affected by up to 25
    procedures … beneficiary has a short length of stay (LOS) and is transferred to …

    http://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/bp102c01.pdf
    Medicare Benefit Policy Manual Chapter 1 – Inpatient Hospital
    appropriateness of admissions, which DRG, if any, to pay, and the
    appropriateness of payment for any … length of time the patient actually spends
    in the hospital. In certain … Patients staying at home, who are ambulatory, whose
    conditions are.

    http://www.ciss.org.mx/pdf/en/studies/CISS-WP-05122.pdf
    The use of DRGs for hospitals' cost containment – CISS
    Example of Hospital Costs and Average Length of Stay Using DRG … accounting
    system of costs, as well as records of hospital admissions and insurance …

    https://www.princeton.edu/~ota/disk3/1983/8306/830608.PDF
    Findings and Conclusions
    oped as a method for characterizing hospitals' case mix using …. DRG payment
    on rates of admissions, lengths of stay, and the use of ancillary, outpatient, and.

    http://www.clinicaltherapeutics.com/article/S0149-2918(14)00083-6/pdf
    Costs and Length of Stay of Drug-Related Hospital Admissions in …
    economic impact, particularly the length of stay (LOS) and direct medical costs (
    DMC), of drug-related hospital admissions and the associated factors in.

    http://www.jblearning.com/samples/0763750344/45561_ch01.pdf
    chapter 1 basic statistical data used in acute care facilities
    Is the average length of stay (ALOS) for these DRGs significantly different from ….
    Inpatient admission: The formal acceptance by a hospital of a patient who is.

    http://www.hca.wa.gov/medicaid/billing/documents/guides/inpatient_hospital_mpg.pdf
    Inpatient Hospital Services Provider Guide – Health Care Authority
    Oct 1, 2014 … Diagnosis related group (DRG) payment method (Inpatient primary ….. Out-of-
    state hospital admissions (does not include hospitals in … What is the agency's
    allowed length of stay (LOS) for MID claims? ………………………….53.

    http://www.uhc.com/live/uhc_com/Assets/Documents/UnitedHealth%20Group%20NQF%20ALOS%20Risk%20Adjustment.pdf
    NQF ALOS Submission Risk Adjustment Methodology …
    California Inpatient Hospital Average Length of Stay (ALOS) Methodology …
    Numerator: Total number of inpatient days of care for the admissions in the ….
    bed days, CMS DRG relative weight and APDRG relative weight by hospital (
    Columns …

    http://www.theradoc.com/pdf/article_010.pdf
    Adverse Drug Events in Hospitalized Patients – TheraDoc
    lated group (DRG), age, sex, acuity, and year of admission; varying numbers of …
    extra length of hospital stay attributable to an ADE was 1.74 days (P<.001).

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2626984/pdf/jnma00895-0078.pdf
    PATIENT "DUMPING" – National Center for Biotechnology Information
    … admissions. From the Queens Hospital Center Affiliation of the Long Island …
    financial class, and lengths of stay of patients who were admitted to the … to a
    diagnosis-related group (DRG) by the Health Care … hospital's 26 151
    admissions.

    http://onlinelibrary.wiley.com/doi/10.1002/ajh.20336/pdf
    Hospital readmission for adult acute sickle cell painful episodes …
    In order to determine the actual pattern of hospital admissions of patients with SS
    and the …. admitted 1,540 times with an average length of stay of 7.6 days.

    http://www.oregon.gov/oha/OHPR/RSCH/docs/Hospital_Report/HospRpt_2003-05.pdf
    Oregon's Acute Care Hospital Report, 2003-2005 – Oregon.gov
    Table 3.01 Physician FTE/100 Adjusted Admissions at DRG Hospitals, … Table
    4.03 Average Length of Stay in Oregon Rural Hospitals, 2003 & 2005…………..27.

    http://www.ucl.ac.uk/~uctpimr/research/LCWShealth.pdf
    Policing Cannabis and Drug Related Hospital Admissions: Evidence …
    Such hospital admissions represent 60% of drug-related healthcare …. Finally,
    the severity of hospital admissions, as measured by the length of stay in hospital,
     …

    http://www.medicine.ox.ac.uk/bandolier/extraforbando/adrpm.pdf
    Adverse drug reactions in hospital patients – Medical Sciences …
    1 To estimate incidence of ADRs causing hospital admission or occurring whilst
    in hospital in the UK ….. a mean age of 65 years with length of stay of 19.5 years.

    http://content.stockpr.com/duratatherapeutics/db/Publications/2134/file/3-13c_SHM_HCUP_Poster.pdf
    RISING UNITED STATES HOSPITAL ADMISSIONS FOR GRAM+ …
    Mar 27, 2014 … Hospital inpatient length of stay has significantly decreased by almost … stay
    since hospital admissions account for a large proportion of healthcare … APR-
    DRG severity of illness/mortality risk and type of infection were the …

    http://www.tcasug.org/files/Rich_Henriksen.pdf
    Healthcare Coding, Billing & Reimbursement Overview
    MS-DRG codes apply only to inpatient admissions and are …… demonstrate
    similar consumption of hospital resources and length-of-stay patterns. □. Has
    been …

    http://www.hospitalefficiencybenchmarks.com/PDFs/ebrochure_new.pdf
    PATIENT "DUMPING" – National Center for Biotechnology Information
    stay (LOS) and days, as compared to benchmark most efficient practice, in order
    to … potentially avoidable days and admissions and to readily allow direct … *All
    Copyrights in and to APR-DRGs are owned by 3M. … hospital, MSA or State
    whose average length of stay (ALOS) (within a 90% confidence limit) fell within.

    https://apachefoundations.cernerworks.com/apachefoundations/resources/APACHE_IV_LOS.pdf
    Intensive care unit length of stay: Benchmarking based on Acute …
    Setting: One hundred and four ICUs in 45 U.S. hospitals. Patients: Patients … ber
    of hospital beds was 478 (range 50–1,030 beds). Among the … diagnoses;
    admission source; length of stay be- fore ICU …… 0.402590257. Cardiac drug
    toxicity.

    http://www.iienet2.org/uploadedfiles/SHSNew/Lessonsfromtopperforminghospitals.pdf
    Reducing Hospital Readmissions: Lessons from Top-Performing …
    means that, in many cases, any hospital admission results in additional ….. and a
    57 percent decrease in average length of stay among participating patients.

    DRG and Hospital Admissions

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    By , November 1, 2013 2:11 pm
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  • DRG and Hospital Admissions

    http://www.ciss.org.mx/pdf/en/studies/CISS-WP-05122.pdf
    The use of DRGs for hospitals’ cost containment – CISS
    The Diagnosis Related Groups (DRGs) to Adjust Payment-Mechanisms ….. accounting system of costs, as well as records of hospital admissions and insurance …

    http://oig.hhs.gov/oei/reports/oai-09-88-00880.pdf
    Unnecessary Admissions to Hospitals – Office of Inspector General
    Enti tIed "National DRG Validation Study, Unnecessary. Admissions to Hospitals " this study was conducted to analyze and profile the characteristics of casesof …

    http://oig.hhs.gov/oei/reports/oei-09-00-00200.pdf
    Medicare Hospital Prospective Payment System: How DRG Rates …
    In this DRG prospective payment system, Medicare pays hospitals a flat rate per case for inpatient …. 3. the appropriateness of admissions and discharges; and.

    http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/AcutePaymtSysfctsht.pdf
    Acute Care Hospital Inpatient Prospective Payment System Fact Sheet
    admission. In addition, hospitals must not separately bill these services to Medicare Part B. Discharges are assigned to diagnosis-related groups (DRG), a  …

    http://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads//clm104c03.pdf
    Medicare Claims Processing Manual – Chapter 3 – Inpatient Hospital
    (DRGs). 20.1 – Hospital Operating Payments Under PPS. 20.1.1 – Hospital …. 100.5 – Review of Hospital Admissions of Patients Who Have Elected Hospice.

    http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/wPOAFactSheet.pdf
    Present on Admission (POA) – Centers for Medicare & Medicaid …
    Related Group (MS-DRG) payments for certain … provision “Hospital-Acquired Conditions and Present … involving Medicare inpatient admissions to general.

    http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/HospitalAcqCond/downloads/hacfactsheet.pdf
    Hospital-Acquired Conditions (HAC) – Centers for Medicare …
    provision “Hospital-Acquired Conditions and Present on Admission Indicator Reporting” (HAC & POA). … Result in the assignment of a case to an MS-DRG.

    http://www.hfs.illinois.gov/assets/hfsweb013.pdf
    Cost Outlier for DRG-Reimbursed Hospitals Admissions on and After …
    3. Non-covered charges. 2. Total charges. 1. DRG code (from paid claim): 15. Marginal cost factor (effective 1/1/95). 14. Gross outlier cost (line 8 – line 13). 7.

    http://www.dhcs.ca.gov/provgovpart/Documents/DRG/5-31-13ProviderBillingFAQ.pdf
    DRG Provider Billing FAQ May 2013 (PDF) – Department of Health …
    Jun 28, 2013 … DRG payment will be made only for admissions on or after July 1, 2013. 2. Will non-contract hospitals accept Medi-Cal patients? All hospitals …

    http://www.princeton.edu/~ota/disk3/1983/8306/830605.PDF
    Chapter 3 DRG Payment and the Use of Medical Technology
    C for detailed descriptions of selected DRG payment … hospital admission, not on the number and types … the hospital’s case mix determined by a DRG-.

    http://www.bcbsks.com/customerservice/providers/Publications/institutional/manuals/workshop/MS-DRGs_PresentOnAdmission.pdf
    MS-DRGs PRESENT ON ADMISSION – Blue Cross and Blue Shield …
    Sep 1, 2008 … Medicare adopted a version of the Yale University’s DRG system into a hospital inpatient …. admission of the patient to the hospital for care.”.

    http://www.rand.org/pubs/reports/2007/R3930.pdf
    The Effects of the DRG-Based Prospective Payment System on …
    comes of Care Before and After Implementation of the DRG-. Based Prospective …. sickness at the time of hospital admission and the quality of hospital care.

    http://www.biotronik.com/files/31B9121B3F6691A2C1257A6B00353264/$FILE/FY%202013%20Medicare%20Reimbursement%20Update.pdf
    BIOTRONIK, Inc. FY 2013 Medicare Reimbursement Update …
    Aug 1, 2012 … Overview of Medicare Reimbursement Logic for Assigning Inpatient. Hospital Admissions to an MS-DRG(Medicare Severity Diagnosis. Related …

    http://www.nber.org/chapters/c7322.pdf
    Medicare Reimbursement and Hospital Cost Growth – National …
    (DRG), an essentially fixed payment for the entire bundle of medical services produced during a hospital admission. DRG outlier payments provide some.

    http://www.dhs.ri.gov/Portals/0/Uploads/Documents/Public/MA%20Reference%20Guides/Hospital/rimap_inp_faq.pdf
    Rhode Island Medicaid APR-DRG Frequently Asked Questions
    Jul 26, 2012 … length of stay plus one day (to reflect additional hospital costs associated with admission). If the calculated amount is less than the DRG base …

    https://www.bcbsnd.com/documents/10476/35335/Acute+Inpatient+(DRGs)%20-+Hospital+Billing.pdf/113f4cdd-a13c-48f3-a690-cafe26d8ad7f
    Acute Inpatient (DRGs) – Hospital Billing – Blue Cross Blue Shield of …
    The DRG system classifies patients into clinically consistent groups with similar … BCBSND requires all acute care hospitals to report Present on Admission …

    https://www.bcbsri.com/sites/default/files/polices/inpatient_%20admission.pdf
    Medical Coverage Policy Inpatient Admission – Blue Cross & Blue …
    Jun 14, 2013 … DRG/Case Rate hospitals. Readmission review involves admissions to an acute, general, short-term hospital occurring less than 30 calendar …

    http://www.oecd.org/els/health-systems/ManagingHospitalVolumes_GermanyandExperiencesfromOECDCountries.pdf
    MANAGING HOSPITAL VOLUMES – Organisation for Economic Co …
    Apr 11, 2013 … DRGs in Germany are almost strictly used for pricing, whereas other ….. day surgeries and ambulatory services related to hospital admission.

    http://www.foxrothschild.com/uploadedFiles/newspublications/maruca_healthOhioHospitalSettles_121409.pdf
    Hospitals Face Admission Denials for Stents, but May Prove Medical …
    Dec 14, 2009 … 7 First RAC Complex Reviews: DRG Targets. 8 News Briefs. Contents. Hospitals Face Admission Denials for. Stents, but May Prove Medical …

    http://faculty.swosu.edu/jerrie.robinson/share/Health%20Care%20Administration/Hospitalt%20reimbursement%20incentive.pdf
    Hospital Reimbursement Incentives: An Empirical Analysis
    avoid costly technologies with little expected benefit. PPS uses essen- tially fixed payments based on the diagnosis-related group (DRG) of a hospital admission.

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